CoChat
Sign Up
Cited by 5Mindfulness and Compassion InterventionsReligion, Spirituality, and PsychologyCancer survivorship and care

Who Benefits Most from a Brief Mindfulness Intervention to Reduce Anxiety During Stereotactic Breast Biopsy: the Moderating Effect of Trait Mindfulness, Spiritual Well-being, and Distress Tolerance

Open access
Ratcliff, Chelsea G., Fowler, Shaelyn N., Sinclair, Kelsey L., Prinsloo, Sarah, Chaoul, Alejandro, Zepeda, Stephanie G., Spelman, Amy, Yang, Wei T. +1 more·2021·Mindfulness
DOI 10.1007/s12671-020-01581-6PMC PMC11823682
Open this paper in CoChat — free account

Abstract

Objectives: This study examined trait mindfulness, spiritual well-being, and distress tolerance as moderators of the effect of a brief mindfulness intervention on anxiety reported during stereotactic breast biopsy (SBB). Methods: This is a secondary analysis of an RCT examining guided meditation (GM; n = 30), focused breathing (FB; n = 30), or standard care (SC; n = 16) on anxiety for women undergoing SBB. Women in GM and FB were guided through their respective interventions for 10 min before and during biopsy. Anxiety (0–10 visual analogue scale), trait mindfulness (FFMQ), spiritual well-being (FACIT-SP), and discomfort intolerance (DI) were assessed at baseline, and anxiety was assessed every 4 min during SBB. Multilevel modeling examined moderator-by-group-by-time interactions. Significant 3-way interactions were decomposed using a median split. Results: FFMQ observing, FFMQ describing, FACIT-SP meaning/peace, and DI moderated the group-by-time effects on anxiety during biopsy (p’s < 0.03). For those high in FFMQ describing, FACIT-SP-Meaning/Peace, or DI, GM was associated with a steeper reduction in anxiety compared to FB and SC (p’s < 0.05). For those low in FFMQ describing, FFMQ observing, and FACIT-SP-Meaning/Peace, both GM and FB were associated with a steeper reduction in anxiety compared to SC (p’s < 0.05). Conclusions: Individuals high in mindful describing, high in the meaning/peace aspect of spiritual well-being, and high in distress intolerance may benefit most from GM. Individuals low in attentional aspects of mindfulness (i.e., describing and observing) and low in the meaning/peace aspect of spiritual well-being may benefit from either a GM or FB intervention. Trial Registration <ref-website><ce_e-address>ClinicalTrial.org</ce_e-address><RefTarget Address="https://clinicaltrials.gov" TargetType="URL" /></ref-website>: (NCT03023215) © 2021, The Author(s), under exclusive licence to Springer Science+Business Media, LLC part of Springer Nature.

Integrity signals

Registry

Crossref · 10.1007/s12671-020-01581-6

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Claims the paper makes

20 of 46 cited sources checked · 8 supported · 1 flagged · accuracy not yet measured

  • Premisecitation

    As little as one hour of mindfulness meditation training can produce valuable but transient decreases in anxiety and pain.

    “A growing number of studies suggest that as little as one hour of training in mindfulness meditation yields valuable, though transient, decreases in anxiety and pain (Arch & Craske, 2006; Erisman & Roemer, 2010; Gutiérrez et al., 2004; Haythornthwaite et al., 2001; Ussher et al., 2014; Zeidan et al., 2010).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Arch & Craske, 2006 source
    • cites Erisman & Roemer, 2010 source

      The Method (Procedure; page unavailable) describes a 10-minute mindfulness intervention. The Results (page unavailable) report less negative affect immediately after an affectively mixed film clip, but no significant difference after recovery. This supports a brief, short-lived effect on negative affect, not the claimed decreases in anxiety and pain, which the study did not measure. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites Gutiérrez et al., 2004 source
  • Premisecitation

    Cancer patients with greater psychosocial vulnerability, such as greater distress, depression, or social isolation, typically derive the greatest benefit from psychosocial interventions.

    “Several studies suggest that cancer patients with greater psychosocial vulnerability (e.g., greater distress, depression, or social isolation) typically derive the greatest benefit from psychosocial interventions (Moyer et al., 2009; Schneider et al., 2010), potentially be due to a “ceiling effect” for well-adjusted patients.”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites Moyer et al., 2009 source

      The Patient Reluctance section discusses patients’ perceived need for psychosocial interventions, and Practical and Logistical Difficulties says group interventions may reduce isolation. Neither reports that patients with greater distress, depression, or isolation benefit more than better-adjusted patients. Searches for greater benefit by baseline vulnerability found no passage addressing that comparison. (LLM, conf=0.75)

      Experimental — accuracy not yet measured
    • cites Schneider et al., 2010 source

      The Discussion (page unavailable) reports that interventions reduced anxiety and depression more when patients had higher initial distress, supporting that part of the claim. The paper mentions evidence concerning low social support in its background, but its meta-analysis did not test social isolation, and it notes studies with opposite findings. Thus it does not establish that patients with all the listed vulnerabilities typically benefit most. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
  • Premisecitation

    Higher pre-procedural anxiety is associated with greater procedural pain.

    “High pre-procedural anxiety levels have been related to increased procedural pain (Miller et al., 2014), longer procedure duration (Schupp et al., 2005), and more appointment cancelations and incomplete procedures (Lang et al., 2000).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Miller et al., 2014 source
  • Premisecitation

    MBSR has been shown to increase spiritual wellbeing.

    “MBSR has been shown to increase spiritual wellbeing, which in turn led to increased mental health-related quality of life (Greeson et al., 2011), decreased depression symptoms (Greeson et al, 2015), and decreased distress and medical symptoms (Carmody et al., 2008).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Greeson et al., 2011 source

      The Outcome analyses report increased daily spiritual experiences and mental health after MBSR. The Discussion describes a preliminary association in which increased spiritual experiences relate to greater mindfulness, which in turn relates to better mental health-related quality of life. It does not establish that increased spiritual wellbeing caused the improvement, as “led to” implies. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Premisecitation

    Women guided in mindfulness-based meditation for 10 minutes before and throughout stereotactic breast biopsy reported a quicker reduction in anxiety during biopsy than women guided in a breathing task or receiving standard care.

    “and another found that women guided in mindfulness-based meditation for 10 minutes before and then throughout SBB reported a quicker reduction in anxiety during the biopsy compared to their counterparts guided in a breathing task or receiving standard care (Ratcliff et al., 2019).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Ratcliff et al., 2019 source
  • May combine two claims. 19
  • Classified as probably not a substantial claim. 37
  • The quote only partly states this claim. 7

  • May combine two claims.

    Premisecitation

    Experimental studies suggest that mindfulness training lasting less than 10 minutes increases willingness to attend to aversive stimuli and paradoxically reduces distress in the face of such stimuli.

    “Indeed, experimental studies suggest that training in mindfulness lasting less than 10 minutes leads to a greater willingness to attend to violent film clips (Erisman & Roemer, 2010), gruesome photos (Arch & Craske, 2006), burn pain (Haythornthwaite et al., 2001), chronic pain (Ussher et al., 2014), and electrical shocks (Gutiérrez et al., 2004), which paradoxically resulted in reduced distress in”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Erisman & Roemer, 2010 source

      The Method (Procedure; page unavailable) specifies a 10-minute mindfulness intervention, not one lasting less than 10 minutes. The Results (Effects of mindfulness intervention; page unavailable) report no significant reduction in negative affect during or after the distressing, violence-related film clip, and do not report measuring willingness to attend to it. Although negative affect was lower after a different, affectively mixed clip, that does not establish the cited claim about violent clips. (LLM, conf=0.88)

      Checked by a reasoning model — may be wrong.

      Experimental — accuracy not yet measured
    • cites Arch & Craske, 2006 source
    • cites Haythornthwaite et al., 2001 source

  • Probably not a substantial claim: may not pass S1 (asserted), S3 (load-bearing).

    Premisecitation

    The effect of MBSR did not depend on pre-treatment mindfulness or spiritual wellbeing.

    “However, another study found that the effect of MBSR did not depend on pre-treatment mindfulness or spiritual wellbeing (Greeson et al., 2015).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Greeson et al., 2015 source

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    The current study is a secondary analysis of a previously reported single-blind randomized controlled trial that compared guided mindfulness meditation, focused breathing, and standard care on anxiety during stereotactic breast biopsy.

    “The goal of the current study was to examine moderators of a previously reported single-blind randomized controlled trial comparing the effect of guided mindfulness meditation (GM) to focused breathing (FB) and standard care (SC) on anxiety reported during SBB (Ratcliff et al., 2019).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Ratcliff et al., 2019 source

  • May combine two claims.

    Premisecitation

    Stereotactic breast biopsy is anxiety-laden for most patients because cancer status is uncertain and the equipment is foreign and uncomfortable.

    “This procedure is laden with anxiety for most patients due to the uncertain nature of cancer status as well as the foreign, uncomfortable equipment (Lang et al., 2006).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Lang et al., 2006 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    A growing body of evidence supports mindfulness-based interventions for a range of positive health-related outcomes.

    “There is a growing body of evidence in support of mindfulness-based interventions for a range of positive health-related outcomes (Howarth et al., 2019).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Howarth et al., 2019 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Increased spiritual wellbeing from MBSR led to decreased depression symptoms.

    “MBSR has been shown to increase spiritual wellbeing, which in turn led to increased mental health-related quality of life (Greeson et al., 2011), decreased depression symptoms (Greeson et al, 2015), and decreased distress and medical symptoms (Carmody et al., 2008).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Greeson et al, 2015 source

      The Results report that increases in daily spiritual experiences were associated with decreases in depressive symptoms after MBSR, and the Discussion says those increases partly explained the symptom improvement. But this observational finding does not establish that increased spiritual wellbeing caused the decrease, as “led to” implies. Page numbers were not available in our copy. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Increased spiritual wellbeing from MBSR led to increased mental health-related quality of life.

    “MBSR has been shown to increase spiritual wellbeing, which in turn led to increased mental health-related quality of life (Greeson et al., 2011), decreased depression symptoms (Greeson et al, 2015), and decreased distress and medical symptoms (Carmody et al., 2008).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Greeson et al., 2011 source

      The Results (Outcome analyses) report increases in daily spiritual experiences and mental health after MBSR. The Discussion says increased spiritual experiences were associated with improved mental health-related quality of life through greater mindfulness, but describes this as preliminary evidence consistent with a possible mechanism. The claim’s 'led to' wording states causation more strongly than the paper supports. (LLM, conf=0.86)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Trait mindfulness and spiritual wellbeing may act synergistically to facilitate posttraumatic growth after a cancer diagnosis.

    “For example, trait mindfulness and spiritual wellbeing may act synergistically to facilitate posttraumatic growth following a cancer diagnosis (Rudaz et al., 2018).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Rudaz et al., 2018 source

      The Abstract’s Methods/Findings and the Discussion report that spiritual mindfulness amplified the association between spiritual coping and perceived personal growth in cancer survivors. But the Method’s measures show that the study assessed spiritual coping and spirituality-related mindfulness, not spiritual well-being and general trait mindfulness; it also measured perceived personal growth rather than posttraumatic growth specifically. No page numbers are available in our copy. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Individuals with greater pre-treatment neuroticism experienced a greater reduction in anxiety after an MBSR course.

    “In contrast, two studies found that individuals with greater pre-treatment neuroticism experienced a greater reduction in distress (de Vibe et al., 2015) and anxiety (Nyklíček & Irrmischer, 2017) after an MBSR course, independent of pre-treatment mood in one case (Nyklíček & Irrmischer, 2017).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Nyklíček & Irrmischer, 2017 source

      The Results report that participants higher in neuroticism showed stronger anxiety decreases in the initial analysis. But after controlling for baseline anxiety, they showed a smaller decrease during the MBSR course and a larger decrease afterward; the overall decrease by three-month follow-up was similar across groups. Thus, the claimed greater reduction independent of pre-treatment mood is not supported as stated. (LLM, conf=0.89)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Individuals with greater pre-treatment neuroticism experienced a greater reduction in distress after an MBSR course.

    “In contrast, two studies found that individuals with greater pre-treatment neuroticism experienced a greater reduction in distress (de Vibe et al., 2015) and anxiety (Nyklíček & Irrmischer, 2017) after an MBSR course, independent of pre-treatment mood in one case (Nyklíček & Irrmischer, 2017).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites de Vibe et al., 2015 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    Because the Meaning and Peace subscales are similar in content and health-related outcomes, they are often combined into a two-factor structure, which the present study uses.

    “However, due to the similarities between Meaning and Peace subscales in content and health-related outcomes, the two are often combined, resulting in a two-factor structure (Peterman et al., 2014). The present study uses this two-factor structure.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Peterman et al., 2014 source

      The Discussion (page not provided) finds Meaning and Peace highly correlated and functionally similar in their associations with health outcomes, and reports that an earlier study found a combined Meaning/Peace component. But this paper finds them empirically distinct; it does not establish that they are often combined because of similarities in content and outcomes. Its Method section (page not provided) excludes Faith and tests one versus two factors for Meaning and Peace, not the claimed two-factor structure of combined Meaning/Peace plus Faith. (LLM, conf=0.85)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Previous literature suggests that even brief mindfulness training can increase distress tolerance and lead to decreased distress.

    “previous literature suggests that even brief training in mindfulness can increase distress tolerance and leading to decreased distress (Mohammed et al., 2018).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Mohammed et al., 2018 source

      The Results (Depression Anxiety and Stress Scale; page unavailable) report decreased anxiety and stress across sessions, but no significant group interaction showing that mindfulness training caused those decreases. The Abstract describes an eight-week intervention, and the Results (Analysis of Pain Perception and Pain Tolerance; page unavailable) measure pain tolerance, not distress tolerance. Thus the paper supports only part of the claim, not its assertion about brief training increasing distress tolerance. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Classified as probably not a substantial claim.

    Study design and conductcitation

    Trait mindfulness was assessed with the 39-item Five Facet Mindfulness Questionnaire, a broadly used measure of nonjudgmental awareness of present-moment experience.

    “Trait mindfulness was assessed with the 39-item Five Facet Mindfulness Questionnaire (FFMQ), which is broadly used in mindfulness literature to determine nonjudgmental awareness of present moment experience (Baer et al., 2006).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Baer et al., 2006 source

      In Deriving Mindfulness Facets (p. 10), the paper selects seven nonreactivity items and eight items for each of four other facets, yielding a 39-item questionnaire that includes awareness and nonjudging. The General Discussion (p. 17) identifies the resulting measure as the FFMQ. It does not establish that the FFMQ was broadly used; instead, it says the measure required extensive additional validation and might be useful in future research. (LLM, conf=0.88)

      Experimental — accuracy not yet measured

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Study design and conductcitation

    The FFMQ is based on a factor analytic study of five independently developed mindfulness questionnaires and yields five factors: observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience.

    “This instrument is based on a factor analytic study of five independently developed mindfulness questionnaires, which yielded five factors of mindfulness: observing, describing, acting with awareness, non-judging of inner experience, and non-reactivity to inner experience.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Baer et al., 2006 source

  • May combine two claims.

    Findingown data

    In the biopsy anxiety analysis, FFMQ-Observing, FFMQ-Describing, FACIT-SP-Meaning/Peace, and distress intolerance each moderated the group-by-time effect on anxiety during stereotactic breast biopsy, with p-values below .03.

    “FFMQ-Observing, FFMQ-Describing, FACIT-SP-Meaning/Peace, and DI moderated the group-by-time effects on anxiety during biopsy (p’s < .03).”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Women low in meaning and peace experienced similar benefit from GM or FB, both leading to steeper anxiety reduction than SC.

    “As with the findings for trait mindfulness, women low in meaning and peace experienced similar benefit from being in GM or FB, both of which led to a steeper reduction in anxiety compared to SC.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Collapsing VAS categories 8 through 10 to create a 0-8 scale affected less than 7% of the anxiety data.

    “This affected <7% of the anxiety data.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Findingown data

    The group × time × nonreaction interaction effect trended toward significance but was not further decomposed.

    “Though the group by time by nonreaction interaction effect trended toward significance (F(2,287) = 2.64, p = 0.073), the interaction was not further decomposed.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    Women high in meaning and peace appeared to derive greater benefit from GM compared to FB or SC, with GM showing steeper anxiety reduction than FB or SC.

    “However, women high in meaning and peace appeared to derive greater benefit from GM compared to FB or SC, with those in GM reporting a steeper anxiety reduction compared to their high meaning and peace counterparts who were in FB or SC.”
    Quote in the paperSubstantial claim

  • May combine two claims.

    Findingown data

    Hispanic/Latina women reported higher baseline VAS anxiety ratings than non-Hispanic/Latina women, but this difference was not statistically significant, p = .189.

    “This may be due to Hispanic/Latina women reporting greater VAS anxiety ratings at the start of the biopsy (M = 4.25, SD = .77) compared to non-Hispanic/Latina women (M = 2.64, SD = .36), though this difference was not statistically significant (p = .189).”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Interpretationown data

    Women high in distress intolerance may benefit most from guided meditation.

    “Individuals high in mindful-describing, high in the meaning/peace aspect of spiritual wellbeing, and high in distress intolerance may benefit most from GM.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Individuals higher in pre-treatment mindfulness experienced greater increases in psychological wellbeing after an MBSR course.

    “One study found that individuals higher in pre-treatment mindfulness experienced greater increases in psychological wellbeing after an MBSR course (Shapiro et al., 2011), suggesting more mindful individuals may have been better able to understand or apply mindfulness training to their lives.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Shapiro et al., 2011 source

  • The quote only partly states this claim.

    Interpretationown data

    Women low in mindful-describing may benefit from either guided meditation or focused breathing.

    “Individuals low in attentional aspects of mindfulness (i.e., describing and observing) and low in the meaning/peace aspect of spiritual wellbeing may benefit from either a GM and FB intervention.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    A willingness to experience and observe physical and emotional stimuli without judgement is integral to mindfulness and leads to tolerance and acceptance of distress.

    “Integral to mindfulness is a willingness to experience and observe physical and emotional stimuli without judgement (Baer, 2003), leading not only to tolerance but acceptance of distress.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Baer, 2003 source

  • The quote only partly states this claim.

    Interpretationown data

    Women low in the meaning/peace aspect of spiritual wellbeing may benefit from either guided meditation or focused breathing.

    “Individuals low in attentional aspects of mindfulness (i.e., describing and observing) and low in the meaning/peace aspect of spiritual wellbeing may benefit from either a GM and FB intervention.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationcitation

    The greater benefit for more vulnerable cancer patients may be due to a ceiling effect among well-adjusted patients.

    “Several studies suggest that cancer patients with greater psychosocial vulnerability (e.g., greater distress, depression, or social isolation) typically derive the greatest benefit from psychosocial interventions (Moyer et al., 2009; Schneider et al., 2010), potentially be due to a “ceiling effect” for well-adjusted patients.”
    Quote in the paperNot a substantial claim

  • Classified as probably not a substantial claim.

    Interpretationcitation

    More mindful individuals may have been better able to understand or apply mindfulness training to their lives.

    “One study found that individuals higher in pre-treatment mindfulness experienced greater increases in psychological wellbeing after an MBSR course (Shapiro et al., 2011), suggesting more mindful individuals may have been better able to understand or apply mindfulness training to their lives.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Insecurely attached individuals experienced a marginally greater reduction in stress following MBSR compared with securely attached individuals.

    “One other study found that insecurely attached individuals experienced a marginally greater reduction in stress following MBSR compared to securely attached individuals (Cordon et al., 2009), suggesting that the intervention may work best for those with more to gain.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Cordon et al., 2009 source

  • The quote only partly states this claim.

    Interpretationown data

    Women low in mindful-observing may benefit from either guided meditation or focused breathing.

    “Individuals low in attentional aspects of mindfulness (i.e., describing and observing) and low in the meaning/peace aspect of spiritual wellbeing may benefit from either a GM and FB intervention.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Premisecitation

    Increased spiritual wellbeing from MBSR led to decreased distress and medical symptoms.

    “MBSR has been shown to increase spiritual wellbeing, which in turn led to increased mental health-related quality of life (Greeson et al., 2011), decreased depression symptoms (Greeson et al, 2015), and decreased distress and medical symptoms (Carmody et al., 2008).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Carmody et al., 2008 source

  • May combine two claims.

    Interpretationreasoning

    Nonpharmacological methods to increase comfort before and during stereotactic breast biopsy can contribute to more efficient cancer prevention procedures, greater patient comfort and satisfaction, and better patient- and institution-level outcomes.

    “Thus, nonpharmacological methods to increase patient comfort before and during SBB can contribute to more efficient cancer prevention procedures, increased patient comfort and satisfaction, and better overall outcomes at the patient and institutional level.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: Anxiolytic medications limit patients from driving or working after stereotactic breast biopsy.

  • Classified as probably not a substantial claim.

    Interpretationcitation

    Mindfulness-based interventions may work best for those with more to gain.

    “One other study found that insecurely attached individuals experienced a marginally greater reduction in stress following MBSR compared to securely attached individuals (Cordon et al., 2009), suggesting that the intervention may work best for those with more to gain.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Interpretationown data

    Women high in the meaning/peace aspect of spiritual wellbeing may benefit most from guided meditation.

    “Individuals high in mindful-describing, high in the meaning/peace aspect of spiritual wellbeing, and high in distress intolerance may benefit most from GM.”
    Quote in the paperSubstantial claim

  • The quote only partly states this claim.

    Interpretationown data

    Women high in mindful-describing may benefit most from guided meditation.

    “Individuals high in mindful-describing, high in the meaning/peace aspect of spiritual wellbeing, and high in distress intolerance may benefit most from GM.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim.

    Study design and conductown data

    The analyses of self-reported data included 76 participants: 30 in guided meditation, 30 in focused breathing, and 16 in standard care.

    “Thus, analyses of self-reported data were conducted on 76 participants (GM = 30; FB = 30, SC = 16).”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    People with low distress tolerance describe physical and emotional discomfort as unbearable or unacceptable and make significant efforts to avoid unpleasant stimuli.

    “Individuals with low distress tolerance describe physical and emotional discomfort as unbearable or unacceptable and make significant efforts to avoid unpleasant stimuli (Simons & Gaher, 2005).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Simons & Gaher, 2005 source

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Brief mindfulness-based interventions are relatively low cost and may produce cost savings during medical procedures through reduced procedure time and reduced need for analgesic medications.

    “Brief mindfulness-based interventions are relatively low cost and may even result in cost savings during medical procedures due to reduced procedure time and reduced need for analgesic medications (Schupp et al., 2005).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Schupp et al., 2005 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    Study staff and medical personnel were not blinded to participants' study condition.

    “Another limitation to acknowledge is that study staff and medical personnel were not blinded to participants’ study condition”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The current sample was underpowered to explore ethnicity as a moderator.

    “However, the current sample was underpowered to further explore this factor.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The FACIT-Sp initially consisted of three factors: Meaning, Peace, and Faith.

    “Initially, this instrument consisted of three factors: Meaning, which measured cognitive aspects of spirituality, Peace, which measured affective dimensions of spirituality, and Faith, which measures the association of one’s illness and beliefs.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Peterman et al., 2002 source

  • May combine two claims.

    Study design and conductreasoning

    The present study lacks a measure to assess the mechanism by which GM or FB reduced anxiety, making it impossible to discern if the anxiety reduction was due to similar or distinct elements.

    “Additionally, the present study does not include a measure to assess the mechanism by which the interventions (GM or FB) reduced anxiety during biopsy, making it impossible to discern if the anxiety reduction seen for women in GM and FB were a result of similar features (e.g., a supportive person present) or distinct but similarly effective elements of each intervention.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    Individuals who report feeling peaceful, having a reason for living, and having a sense of purpose may be particularly poised to take advantage of non-judgmental awareness elements of mindfulness intervention, but relatively unaffected by focusing on deep breathing.

    “It may be that individuals who report feeling peaceful, having a reason for living, and having a sense of purpose in their lives are particularly poised to take advantage of the non-judgmental awareness elements central to a mindfulness intervention, but are relatively unaffected by simply focusing on deep breathing.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The FFMQ facets are moderately intercorrelated, indicating that they are related but distinct aspects of mindfulness.

    “Additionally, the facets are moderately intercorrelated, indicating that though the facets are related, they represent distinct aspects of mindfulness.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductcitation

    The Distress Intolerance Scale is a unidimensional 5-item self-report measure of perceived intolerance of physical discomfort.

    “The Distress Intolerance Scale is a unidimensional 5-item self-report measure of perceived intolerance of physical discomfort (Schmidt et al., 2006).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Schmidt et al., 2006 source

  • Classified as probably not a substantial claim.

    Study design and conductreasoning

    Patients planning to use anxiolytics during the biopsy were not included in the study.

    “and patients planning to use anxiolytics during the biopsy were not included in order to better determine the effect of the intervention on anxiety during the biopsy.”
    Quote in the paperSubstantial claim

  • Classified as probably not a substantial claim. May combine two claims.

    Study design and conductcitation

    Participants were randomized to guided meditation, focused breathing, or standard care in a 2:2:1 ratio using minimization according to age, menopausal status, BI-RADS category, awareness of BI-RADS category, and use of medications with possible anxiolytic effects.

    “They then completed a 20-minute baseline questionnaire, including measures of trait mindfulness, spiritual wellbeing, and distress intolerance, and were randomized to GM, FB, or SC (2:2:1) using minimization, a form of adaptive randomization (Pocock, 1983), according to age, menopausal status, Breast Imaging and Data System (BI-RADS) category used to describe mammogram findings, patient awareness”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Pocock, 1983

      Couldn’t be matched to a paper in Crossref, so it can’t be checked.

  • The quote only partly states this claim.

    Interpretationcitation

    The finding that women high in describing in GM had steeper anxiety reduction than those in FB or SC is consistent with Shapiro and colleagues' finding that individuals higher in trait mindfulness benefited more from MBSR.

    “This finding, which is contrary to hypothesis, is consistent with Shapiro and colleagues’ finding that individuals higher in trait mindfulness benefited more from MBSR compared to those lower in trait mindfulness (2011).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [2011]

      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 conductcitation

    The FACIT-Sp is a 12-item measure developed to assess spiritual well-being among medically ill populations.

    “The Functional Assessment of Chronic Illness Therapy-Spiritual Well-being (FACIT-Sp) is a 12-item measure developed to assess of spiritual well-being among medically ill populations (Peterman et al., 2002).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Peterman et al., 2002 source

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The present study cannot determine mechanisms of the effect of GM on anxiety reduction for women high in distress intolerance.

    “Though the present study cannot determine mechanisms of this effect”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Interpretationreasoning

    The lack of moderation by acceptance aspects may be due to low power or may indicate that mindful acceptance is not a relevant predictor.

    “This may be due to relatively low power to detect a significant effect, or may indicate that mindful acceptance is not a relevant predictor.”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Study design and conductnone given

    Participants were blinded to the study's purpose.

    “However, participants were blinded the study’s purpose”
    Quote in the paperNot a substantial claim

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductreasoning

    Ethnicity and the baseline level of the respective outcome variable were the only covariates entered in all analyses.

    “Thus, ethnicity and the baseline level of the respective outcome variable were entered as the only covariates in all analyses.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    Some elements of trait mindfulness, spiritual wellbeing, and distress intolerance moderated the intervention effect on anxiety during biopsy, but the direction of these effects was not always as expected.

    “As hypothesized, some elements of trait mindfulness, spiritual wellbeing, and distress intolerance did moderate the effect of the intervention on anxiety during the biopsy, but the direction of these effects was not always in the expected direction.”
    Quote in the paperSubstantial claim

  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    Individuals unlikely to observe and describe their experience may have perceived GM and FB as very similar because both involved a reminder to breathe and both provided supportive attention from a mind-body specialist.

    “This may be because individuals unlikely to observe and describe their experience perceived the GM and FB as very similar, both involved a reminder to breath and both provided supportive attention from a mind-body specialist.”
    Quote in the paperNot a substantial claim
54 of 54

  • The paper relies on this without support.

    No other studies have examined moderators of mindfulness-based interventions, including brief mindfulness interventions.

    “To the best of our knowledge, no other studies have examined moderators of mindfulness-based interventions, leaving open the question of who may benefit most”

  • The paper relies on this without support.

    Anxiolytic medications limit patients from driving or working after stereotactic breast biopsy.

    “and limit patients from driving or working after the procedure.”
2 of 2

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.

  • ConsistentF(2, 287) = 3.48reported p = .0322 · recomputed p = .032

    “F(2,287) = 3.48, p = .0322”

  • ConsistentF(2, 168) = 10.5reported p < .001 · recomputed p < .001

    “F(2,168) = 10.5, p < .001”

  • ConsistentF(2, 287) = 3.67reported p = .027 · recomputed p = .027

    “F(2,287) = 3.67, p = .027”

  • ConsistentF(2, 137) = 7.61reported p < .001 · recomputed p < .001

    “F(2,137) = 7.61, p < .001”

  • ConsistentF(2, 287) = 2.64reported p = .073 · recomputed p = .073

    “F(2,287) = 2.64, p = .073”

  • ConsistentF(2, 279) = 4.66reported p = .0102 · recomputed p = .010

    “F(2,279) = 4.66, p = .0102”

  • ConsistentF(2, 165) = 3.95reported p = .021 · recomputed p = .021

    “F(2,165) = 3.95, p = .021”

  • ConsistentF(2, 123) = 4.76reported p = .01 · recomputed p = .010

    “F(2,123) = 4.76, p = .010”

  • ConsistentF(2, 283) = 3.31reported p = .038 · recomputed p = .038

    “F(2,283) = 3.31, p = .038”

  • ConsistentF(2, 154) = 7.29reported p < .001 · recomputed p < .001

    “F(2,154) = 7.29, p < .001”

10 of 10

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Abstract overstates the benefit of meditation for high-describing participants

    Major

    The abstract says guided meditation outperformed both comparison groups for participants high in FFMQ-Describing. The detailed results report a difference from focused breathing, but no difference from standard care.

  • Distress-intolerance interaction exceeds the abstract's p-value threshold

    Minor

    The abstract places the DI moderation result below .03, whereas the detailed result gives p = .038.

  • Observing interaction exceeds the abstract's p-value threshold

    Minor

    The abstract places the FFMQ-Observing moderation result below .03, whereas the detailed result gives p = .0322.

3 of 3

Cites

Flagged first, then by citations

1 of the 57 references couldn’t be matched to a known paper.

Cited by

Sorted by citations

Related

Authors
Ratcliff, C. G., Fowler, S. N., Sinclair, K. L., Prinsloo, S., Chaoul, A., Zepeda, S. G., Spelman, A., Yang, W. T., & Cohen, L.
Affiliations
  • Baylor College of Medicine (US)
  • Sam Houston State University (US)
  • The University of Texas MD Anderson Cancer Center (US)
  • Our Lady of the Lake University (US)
Corresponding author
Ratcliff, Chelsea G.
ORCID
Venue
Mindfulness
Publisher
Springer Science and Business Media LLC
Published
2021-01-13
Volume
12
Issue
5
Pages
1127-1137
ISSN
  • 1868-8527 (ISSN-L)
  • 1868-8535
DOI
10.1007/s12671-020-01581-6
PMC
PMC11823682
OpenAlex
W3119456066
Cited by
5
References
57
Citations by year
2026: 2 · 2024: 1 · 2023: 1 · 2022: 1
FWCI
0.51
Type
journal article
Language
en
Open access
Licence
Locations
  • Mindfulness (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
Division of Cancer Epidemiology and Genetics, National Cancer Institute (R25T CA057730, A016672)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Social Sciences › Health › Religion, Spirituality, and Psychology
  • Health Sciences › Medicine › Oncology › Cancer survivorship and care
Keywords
mindfulness-based interventions, anxiety, stereotactic breast biopsy, trait mindfulness, spiritual well-being, distress tolerance, guided meditation, moderating effect, breast cancer, preprocedural anxiety

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 by deepseek-v4.1-flash 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