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Mindfulness, acceptance, and emotion regulation: perspectives from Monitor and Acceptance Theory (MAT)
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Abstract
Experiential acceptance-an orientation of receptivity and noninterference with present-moment experiences-is described as central to mindfulness interventions, yet little experimental work has tested acceptance as a mechanism for mindfulness intervention effects. Guided by Monitor and Acceptance Theory (MAT), this review situates acceptance as an emotion regulation mechanism and reviews self-report mindfulness literature showing that attention monitoring skills are only associated with beneficial mental and physical health outcomes when accompanied by acceptance skills. New experimental dismantling work shows that removing acceptance training from mindfulness interventions reduces their efficacy for improving stress, positive emotion, and social relationship outcomes. Overall, converging evidence demonstrates that acceptance is a critical emotion regulation mechanism of mindfulness interventions. This work advances basic research, has translational value, and offers opportunities for future research.
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“Mindfulness, or compassionate acceptance of present-moment experiences, is thought to reduce emotional barriers to advance care planning [30]. By increasing distress tolerance or acceptance of unpleasant thoughts and feelings, mindfulness practices may reduce emotional reactivity during end-of-life discussions [31].”
From Mindfulness to enhance quality of life and support advance care planning: a pilot randomized controlled trial for adults with advanced cancer and their family caregivers. (2024) · cites this paper as [31]
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“First, mindfulness practices increase distress tolerance by facilitating compassionate awareness of thoughts and feelings [31].”
From Mindfulness to enhance quality of life and support advance care planning: a pilot randomized controlled trial for adults with advanced cancer and their family caregivers. (2024) · cites this paper as [31]
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Emotion-regulation strategies across psychopathology: A meta-analytic review
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“In contrast, ineffective emotion regulation is a core feature of psychopathology [9], and a growing body of evidence relates non-acceptance—including experiential avoidance [10,11], emotional non-acceptance [12], and distress intolerance [13]—with clinical symptoms.”
Loneliness and Social Isolation as Risk Factors for Mortality: A Meta-Analytic Review
Holt-Lunstad, J., Smith, T. B., Baker, M., Harris, T., & Stephenson, D. (2015) · Perspectives on Psychological Science · doi:10.1177/1745691614568352 · Cited by 6,043
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“tion as a central mechanism for the effects of mindfulness on mental and physical health outcomes, acting to reduce affective and physiological reactivity and promote recovery [7].”
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“And indeed, meta-analytic evidence shows that emotion regulation processes mediate the effects of mindfulness interventions on improvements in mental health [8].”
Kashdan, T. B., Barrios, V., Forsyth, J. P., & Steger, M. F. (2006) · Behaviour Research and Therapy · doi:10.1016/j.brat.2005.10.003 · Cited by 994 · cited 1×
“In contrast, ineffective emotion regulation is a core feature of psychopathology [9], and a growing body of evidence relates non-acceptance—including experiential avoidance [10,11], emotional non-acceptance [12], and distress intolerance [13]—with clinical symptoms.”
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
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Garland, E. L., Farb, N. A., R. Goldin, P., & Fredrickson, B. L. (2015) · Psychological Inquiry · doi:10.1080/1047840x.2015.1064294 · Cited by 810
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Research works printed but not linked: 1
- Chin B, Lindsay EK, Greco CM, Brown KW, Wright AG, Smyth JM, et al.: Acceptance skills drive stress resilience in a mindfulness training randomized controlled trial. under review.
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Qin, Q. Q., Wang, W., & Wang, A. (2026) · Mindfulness · doi:10.1007/s12671-026-02887-7
Михайловна, Б. П., Smith, L. M., Riordan, K. M., Simonsson, O., Dottori, L. T., Song, H. Q., Shashko, N. S., Tatar, R., Baldwin, S. A., Bernstein, A., et al. (2026) · JMIR Mental Health · doi:10.2196/90602
Liu, X., Mi, S. Q., Zeng, J. Y., & Zhang, Y. (2026) · Journal of Happiness Studies · doi:10.1007/s10902-026-01071-x
Tarrasch, R., Kassem-Agbaria, F., & Polansky, R. A. (2026) · Research Square · doi:10.21203/rs.3.rs-9972803/v1
Fan, Q., Han, X., & Zhao, F. (2026) · Current Psychology · doi:10.1007/s12144-026-09727-w
Zhao, C., Sun, Y., & Zhang, W. (2026) · Behavioral Sciences · doi:10.3390/bs16071128
Schroevers, M. J., Wang, J., Elabd, Z., & Koster, F. (2026) · Counselling and Psychotherapy Research · doi:10.1002/capr.70182
Congard, A., Sapin, A., Bret, A., Fleury‐Bahi, G., Boudoukha, A. H., Navarro, O., Meillerais, S., Khocha, A., & Galharret, J. (2026) · Health Psychology Report · doi:10.5114/hpr/221135
The Effects of Mindfulness on Reducing Guilt and Self-punishment
Li, W., Zhang, Y., Bian, W., Wang, Y., & Li, H. (2026) · Mindfulness · doi:10.1007/s12671-026-02936-1
Arpacı, R., & Tanrıverdi, D. (2026) · Current Psychology · doi:10.1007/s12144-026-09834-8
Heldal, R., Skredsvig, M., Hoff, F. G. D., & Vøllestad, J. (2026) · Mindfulness · doi:10.1007/s12671-026-02964-x
Wei, Y., Sun, L., Xue, J., Chen, C.-S., & Chen, S.-L. (2026) · Journal of Clinical Psychology · doi:10.1002/jclp.70205
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Mindfulness and Spiritual Intelligence: A Systematic Review
Aldbyani, A., Alhimaidi, A., Shen, C., & Liu, J. (2026) · Behavioral Psychology/Psicología Conductual · doi:10.31083/bp51046
Mesghina, A., & Richland, L. E. (2026) · Mindfulness · doi:10.1007/s12671-026-02995-4
Negative Affect Links Negative Feedback to Cognitive and Motivational EngagementPreprint
Hennemann, L., Kotte, S. C., & Scharf, F. (2026) · Research Square · doi:10.21203/rs.3.rs-11076112/v1
Chung, D., Zhang, Z., & Wang, J. (2026) · Behavioral Sciences · doi:10.3390/bs16111983
Settawacharawanich, S., Jarukasemthawee, S., & Feldman, D. B. (2026) · Mental Health Religion & Culture · doi:10.1080/13674676.2026.2666216
Chen, W., Hammett, J. F., Juwadi, K., Bahrami, R., & Davis, K. C. (2026) · Journal of Aggression Maltreatment & Trauma · doi:10.1080/10926771.2026.2754869
Metadata
- Authors
- Lindsay, E. K., & Creswell, J. D.
- Affiliations
- University of Pittsburgh (US)
- Carnegie Mellon University (US)
- Corresponding author
- Lindsay, Emily K
- Venue
- Current Opinion in Psychology
- Publisher
- Elsevier BV
- Published
- 2019-08
- Volume
- 28
- Pages
- 120-125
- ISSN
- 2352-250X (ISSN-L)
- PMC
- PMC6565510
- OpenAlex
- W2912349592
- Semantic Scholar
- 59bfb00e1c6bebc9fce0ba1d01462527ca627f0b
- Cited by
- 220
- References
- 65
- Citations by year
- 2026: 46 · 2025: 39 · 2024: 48 · 2023: 20 · 2022: 31 · 2021: 26 · 2020: 8 · 2019: 1
- FWCI
- 1.48
- Type
- journal article
- Language
- en
- Open access
- green
- doi.org
- Locations
- Current Opinion in Psychology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- MindRxiv (OSF Preprints) (submittedVersion, cc-by)
- MindRxiv (OSF Preprints) (submittedVersion)
- Funders
- National Institutes of Health (R01AT008685, F32AT009508, R21AT008493)
- National Center for Complementary and Integrative Health (NCCIH)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
- Keywords
- mindfulness, acceptance, emotion regulation, attention monitoring, mindfulness-based interventions, stress, positive emotions, interpersonal relationships
- MeSH terms
- Emotional Regulation, Humans, Psychological Theory, Mindfulness
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