Psychological mechanisms driving stress resilience in mindfulness training: A randomized controlled trial.
Open accessAbstract
OBJECTIVE: Mindfulness interventions have been shown to reduce stress; however, the mechanisms driving stress resilience effects are not known. Mindfulness interventions aim to teach individuals how to: (a) use attention to monitor present moment experiences; with (b) an attitude of acceptance and equanimity. A randomized controlled dismantling trial (RCT) was conducted to test the prediction that the removal of acceptance skills training would eliminate stress-reduction benefits of a mindfulness intervention. METHOD: This preregistered RCT randomly assigned stressed community adults to 1 of 3 conditions: (a) Monitor and Accept (MA) mindfulness training, a standard 8-week Mindfulness-Based Stress Reduction (MBSR) intervention that provided explicit instruction in developing both monitoring and acceptance skills; (b) Monitor Only (MO) mindfulness training, a well-matched 8-week MBSR intervention that taught monitoring skills only; or (c) No Treatment (NT) control. Stress and nonjudgment were measured using ecological momentary assessment (EMA) for 3 days at baseline and 3 days at postintervention. RESULTS: Consistent with predictions, MA participants increased in nonjudgment and decreased in both stress ratings and the proportion of assessments that they reported experiencing feelings of stress in daily life, relative to both MO and NT participants. CONCLUSIONS: This RCT provides one of the first experimental tests of the mechanisms linking mindfulness interventions with stress resilience. These findings suggest that acceptance skills training may be a necessary active ingredient and support the value of integrating acceptance skills training into stress-reduction interventions. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Monitoring and acceptance skills and decentering have been postulated as main mechanisms of change in mindfulness-based interventions.
“Monitoring and acceptance skills and “decentering” (the ability to observe one’s thoughts and feelings as transient, objective events in the mind) have been postulated as main mechanisms of change (Chin et al., 2019; Moore et al., 2022).”
From Online Mindfulness-Based Cognitive Therapy for People with Parkinson’s Disease and Their Caregivers: a Pilot Study (2022) · cites this paper as Chin et al., 2019
The paper’s discussion describes monitoring and acceptance as components of mindfulness training and identifies acceptance skills as a possible mechanism for reducing stress. It does not identify decentering as a mechanism of change or describe thoughts and feelings as transient, objective events; a search for “decentering” found no such passage. The cited paper therefore supports only part of the attributed statement. (LLM, conf=0.86)
Experimental — accuracy not yet measuredThe mechanism guiding the effects of mindfulness training on mindfulness, depression and insomnia seems to be the increase in mindful attitude towards one's own experience, in particular in terms of acceptance, nonreactivity and nonjudgment.
“The effects of mindfulness training on mindfulness, depression and insomnia are now quite renowned8,10,21,53 and the mechanism guiding all these changes seems to be the increase in mindful attitude towards one’s own experience, in particular in terms of acceptance, nonreactivity and nonjudgment54–57.”
From Mindfulness-based online intervention increases well-being and decreases stress after Covid-19 lockdown (2022) · cites this paper as [55]
The Discussion reports that acceptance training increased non-judgment and may help explain mindfulness training’s stress-reduction benefits. It does not establish this mechanism for changes in depression or insomnia; the Discussion also says the study could not test whether non-judgment mediated the stress effect. (LLM, conf=0.88)
Experimental — accuracy not yet measuredIn analyses from the same parent study, all groups showed decreases in momentary stress over time (MA d .85; MO d .59; NT d .44).
“All groups showed decreases in reports of momentary stress over time (MA: d= .85; MO: d= .59; NT: d=.44).”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin et al. (2019)
Ratings of momentary stress and nonjudgment were taken concurrently, which prevented testing the proposed mediation model.
“ratings of momentary stress and nonjudgment were taken concurrently, which precluded testing of the actual mediation model proposed by these authors.”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin et al. (2019)
The articles from the parent study demonstrate that several psychological outcomes (positive affect, stress) were substantially improved with the inclusion of an acceptance skills component.
“The articles based on this parent study demonstrate that several psychological outcomes (positive affect, stress) were substantially improved with the inclusion of an acceptance skills component”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin et al. (2019)
These MBSR articles derived from the same parent study in which MBSR was dismantled by removing acceptance training skills to compare present moment monitoring plus acceptance versus monitoring alone.
“These were derived from the same parent study in which MBSR was dismantled by removing the acceptance training skills from the full program in order to compare the effect of present moment monitoring plus an attitude of acceptance versus present moment monitoring alone (Chin, Lindsay, Greco, Brown, Smyth, Wright, et al., 2019; Lindsay, Chin, et al., 2018).”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin, Lindsay, Greco, Brown, Smyth, Wright, et al., 2019
All participants increased in reports of nonjudgement (MA d .88; MO d .73; NT d .31); MA increased nonjudgement significantly more than MO (d .16) and NT (d .56); MO increased compared to NT (d .39).
“all participants increased in their reports of nonjudgement (MA: d= .88; MO: d= .73; NT: d= .31), and MA increased nonjudgement significantly more than MO (d= .16) and NT (d= .56). Additionally, MO increased in nonjudgment compared to NT (d= .39).”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin et al. (2019)
MA showed a significantly greater decrease in momentary stress ratings than MO (d .27) and NT (d .40), and MO and NT did not differ significantly (d .13).
“the MA group showed a significantly greater decrease in momentary stress ratings compared to MO (d= .27) and to NT (d= .40) and there was no significant difference in stress reduction between MO and NT (d= .13).”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin et al. (2019)
All groups reported a decrease in number of daily stress occasions (MA d .73; MO d .36; NT d .16); the change was significantly greater for MA than MO (d .38) and NT (d .62), with no significant difference between MO and NT (d .22).
“all groups reported a decrease from pre- to post-program (MA: d = .73; MO: d = .36; NT: d = .16), and this change was significantly greater for MA compared to both MO (d= .38) and NT (d= .62). No significant difference in magnitude of change was found between MO and NT (d= .22).”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin et al. (2019)
Cultivating an attitude of nonjudgement remains a promising but unconfirmed mechanism of the effect of acceptance skills on outcomes.
“cultivating an attitude of nonjudgement remains a promising, if yet unconfirmed, mechanism of this effect.”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin et al. (2019)
In a series of high-quality studies comparing present moment monitoring alone to monitoring plus acceptance, participants randomized to the acceptance condition had significantly improved outcomes in positive affect, negative affect, daily stress, social interactions, and physiological stress reactivity compared to monitoring-only and control conditions.
“researchers show that those randomized to the condition including acceptance had significantly improved outcomes in terms of positive affect, negative affect, daily stress, social interactions, and physiological stress reactivity compared to the monitoring only and control conditions”
From Dismantling Mindfulness-Based Programs: a Systematic Review to Identify Active Components of Treatment (2020) · cites this paper as Chin, Lindsay, Greco, Brown, Smyth, Aidan, et al., 2019
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- Authors
- Chin, B., Lindsay, E. K., Greco, C. M., Brown, K. W., Smyth, J. M., Wright, A. G. C., & Creswell, J. D.
- Affiliations
- Carnegie Mellon University (US)
- University of Pittsburgh (US)
- Virginia Commonwealth University (US)
- Pennsylvania State University (US)
- Corresponding author
- Creswell, J. David
- ORCID
- Venue
- Health Psychology
- Published
- 2019-08
- Volume
- 38
- Issue
- 8
- Pages
- 759-768
- ISSN
- 0278-6133 (ISSN-L)
- 1930-7810
- PMC
- PMC6681655
- OpenAlex
- W2945970821
- Cited by
- 103
- References
- 34
- Citations by year
- 2026: 14 · 2025: 15 · 2024: 12 · 2023: 19 · 2022: 13 · 2021: 12 · 2020: 15 · 2019: 2 · 2018: 1
- FWCI
- 12.26
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Health Psychology (publishedVersion, other-oa)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health (R21AT008493; R01AT008685, F32AT009508)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Social Sciences › Psychology › Social Psychology › Psychological Well-being and Life Satisfaction
- Social Sciences › Psychology › Applied Psychology › Digital Mental Health Interventions
- Keywords
- mindfulness training, stress resilience, non-judgment, mindfulness-based stress reduction, attention monitoring, community-dwelling adults
- MeSH terms
- Adolescent, Adult, Aged, Female, Humans, Male, Middle Aged, Stress, Psychological, Young Adult, Mindfulness
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