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Cited by 8Mindfulness and Compassion InterventionsAsthma and respiratory diseasesAnxiety, Depression, Psychometrics, Treatment, Cognitive Processes

Evaluating the role of mindfulness in terms of asthma-related outcomes and depression and anxiety symptoms among individuals with asthma.

Open access
Kraemer, Kristen M., McLeish, Alison·2019·Psychology, Health & Medicine
DOI 10.1080/13548506.2018.1529326PMC PMC6741348
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Abstract

The aim of the current study was to examine the unique role of mindfulness skills in terms of: (1) asthma-related outcomes (i.e., asthma control, asthma quality of life); (2) depression symptoms; and (3) anxiety symptomatology (i.e., anxiety sensitivity, panic symptoms, global anxiety) among non-smoking adults with current asthma. Participants were 61 (61.9% female; M age = 34.72 years, SD = 13.58, range = 18-65) non-smoking adults with current asthma who completed a battery of self-report measures. Results indicated that, after controlling for the effects of race and age, greater ability to describe present moment experiences was significantly associated with better asthma-related quality of life and lower levels of anxiety symptoms. Though mindfulness skills together were associated with lower levels of panic symptoms, there were no significant individual associations between specific skills and panic symptoms. Greater nonjudgment of present moment experiences was associated with lower levels of anxiety and anxiety sensitivity. Greater nonreactivity was significantly associated with lower levels of depression symptoms and anxiety sensitivity. Lastly, a greater ability to observe present moment experiences was associated with lower levels of anxiety sensitivity. Mindfulness was not significantly associated with asthma control. These findings suggest that it may be useful to target the mindfulness skills of describing, nonjudgment, and nonreactivity among individuals with asthma, particularly those with elevated levels of anxiety and depression, in order to improve psychological and asthma-related outcomes.

Integrity signals

Registry

Crossref · 10.1080/13548506.2018.1529326

Cites

56 of 56 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

6 of 26 cited sources checked · 3 supported · 0 flagged · accuracy not yet measured

  • Premisecitation

    Among people with asthma, higher anxiety and depression are linked to several worse asthma outcomes.

    “Elevated anxiety and depression among those with asthma (Goodwin et al., 2010; Opolski & Wilson, 2005) is associated with a number of negative asthma-related outcomes (Afari, Schmaling, Barnhart & Buchwald, 2001; Deshmukh et al., 2008; Eisner, Katz, Lactao, & Irbarren, 2005; Kullowatz et al., 2007).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Goodwin et al., 2010 source
    • cites Opolski & Wilson, 2005 source

      The citation to Opolski and Wilson is attached to the statement that anxiety and depression are elevated among people with asthma; the later outcome claim has separate citations. In “Are people with asthma more likely to be depressed?” (page unavailable), the review says most authors suggest increased depression prevalence, while noting mixed findings. Our copy does not establish elevated anxiety among people with asthma. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites Afari, Schmaling, Barnhart & Buchwald, 2001 source
  • Premisecitation

    Mindfulness, viewed as a trait-like quality that can be increased through practice, may relate to lower mood and anxiety symptoms and related risk factors in people with asthma.

    “Mindfulness, conceptualized as a trait-like factor that can be increased through formal or informal practices (Brown & Ryan, 2003; Baer, Smith, & Allen, 2004), may be associated with lower levels of mood and anxiety symptomatology and risk factors for these disorders among individuals with asthma (Keng, Smoski, & Robins, 2011).”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites Brown & Ryan, 2003 source
    • cites Baer, Smith, & Allen, 2004 source
    • cites Keng, Smoski, & Robins, 2011 source

      The review’s “Relationship between Trait Mindfulness and Psychological Health” section reports negative correlations between mindfulness and depression, social anxiety, and several related factors. Its “Mechanisms of Effects of Mindfulness Interventions” section also reports that training can increase trait mindfulness. Neither passage establishes these associations specifically among people with asthma; page numbers were not provided. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • Findingown data

    In regression controlling for age and race, greater Describing was significantly associated with better asthma-related quality of life (β = .35, t = 2.46, p < .05).

    “though Describing emerged as a significant individual variable (β = .35, t = 2.46, p < .05).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The associations between mindfulness skills and outcomes are not explained by unmeasured confounding variables beyond age and race.
  • Findingown data

    In zero-order correlations, Observing had no significant associations with any study variable.

    “There were no significant associations between Observing and any study variables.”
    Quote in the paperNot a substantial claim
  • Findingown data

    In zero-order correlations, Acting with Awareness was significantly correlated with anxiety sensitivity.

    “Acting with Awareness was significantly correlated with AS.”
    Quote in the paperNot a substantial claim
  • Classified as probably not a substantial claim. 17
  • May combine two claims. 15
  • The quote only partly states this claim. 3

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

    Premisecitation

    Some evidence indicates that mindfulness-based interventions may help depression and anxiety in primary care settings.

    “There is some evidence that mindfulness-based interventions may be effective for depression and anxiety in primary care settings (e.g., Finucane & Mercer, 2006).”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites Finucane & Mercer, 2006 source

  • May combine two claims.

    Premisecitation

    Pbert and colleagues found that an MBSR group had 12-month improvements in asthma-related quality of life and perceived stress and used fewer short-acting bronchodilators than controls, with no significant lung function changes.

    “Pbert and colleagues (2012) found that, compared to those in the control condition, individuals in a mindfulness-based stress reduction (MBSR) group demonstrated 12-month improvements in asthma-related quality of life, perceived stress, and decreased use of short-acting bronchodilators despite no significant changes in lung function.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites Pbert et al., 2012 source

  • May combine two claims.

    Premisecitation

    Higher global mindfulness has been linked to better asthma-related quality of life and higher odds of asthma diagnosis, persistent dry cough, and wheezing in adolescents and college students.

    “Higher levels of global mindfulness have also been shown to be associated with better asthma-related quality of life and an increase in the odds of having an asthma diagnosis, persistent dry cough, and wheezing among adolescents and college students (Cillessen, van de Ven, & Karremans, 2017; Shi et al., 2017).”
    Quote in the paperSubstantial claim1 of 2 sources checked
    • cites Cillessen, van de Ven, & Karremans, 2017 source
    • cites Shi et al., 2017 source

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

    Premisecitation

    A large literature supports the excellent psychometric properties of the Center for Epidemiological Studies Depression Scale.

    “There is a large body of literature that supports the excellent psychometric properties of the CES-D (Radloff, 1977; Radloff, 2002).”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites Radloff, 1977 source

      In “Generalizability Across Subgroups” (page unavailable), Radloff reports high internal consistency, acceptable test–retest stability, excellent concurrent validity, and substantial construct validity for the CES-D. This supports the claim about favorable psychometric properties, but this 1977 paper reports its own findings rather than establishing that a large body of literature supports them. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites Radloff, 2002

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

  • The quote only partly states this claim.

    Findingown data

    In regression controlling for age and race, greater Nonjudgment (β = −.34, t = −2.51, p < .05) and Nonreactivity (β = −.74, t = −2.36, p < .05) were significantly associated with lower depression symptoms.

    “In terms of depression symptoms, step one of the model was not significant. Step two of the model accounted for 33.0% of variance, and Nonjudgment (β = −.34, t = −2.51, p < .05) and Nonreactivity (β = −.74, t = −2.36, p < .05) were the only significant variables.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The associations between mindfulness skills and outcomes are not explained by unmeasured confounding variables beyond age and race.

  • May combine two claims.

    Findingown data

    In zero-order correlations, Describing was negatively related to age, depressive symptoms, anxiety symptoms, panic symptoms, and anxiety sensitivity, and positively related to asthma control and asthma-related quality of life.

    “Describing was significantly negatively associated with age, depressive symptoms, anxiety symptoms, panic symptoms, and AS, and positively associated with asthma control and asthma-related quality of life.”
    Quote in the paperSubstantial claim

  • May combine two claims. The quote only partly states this claim.

    Findingown data

    In regression controlling for age and race, greater Observing (β = .50, t = 3.14, p < .01), Nonjudgment (β = −.35, t = −2.72, p < .01), and Nonreactivity (β = −.36, t = −2.30, p < .05) were significantly associated with anxiety sensitivity.

    “In terms of AS, step one of the model was not significant. Step two of the model was significant and accounted for 45.9% of unique variance. Observing (β = .50, t = 3.14, p < .01), Nonjudgment (β = −.35, t = −2.72, p < .01), and Nonreactivity (β = −.36, t = −2.30, p < .05) were significant variables at step two.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The associations between mindfulness skills and outcomes are not explained by unmeasured confounding variables beyond age and race.

  • May combine two claims.

    Findingown data

    In zero-order correlations, Nonreactivity was negatively related to age and depressive symptoms, and positively related to asthma control and asthma quality of life.

    “Nonreactivity was significantly negatively associated with age, and depressive symptoms, and positively associated with asthma control and asthma quality of life.”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Findingown data

    In zero-order correlations, Nonjudgment was significantly related to anxiety symptoms, anxiety sensitivity, depressive symptoms, and panic symptoms.

    “Nonjudgment was significantly associated with anxiety symptoms, AS, depressive symptoms and panic symptoms.”
    Quote in the paperNot a substantial claim

  • The quote only partly states this claim.

    Findingown data

    In regression controlling for age and race, greater Describing (β = −.46, t = −2.77, p < .01) and Nonjudgment (β = −.38, t = −2.79, p < .01) were significantly associated with lower anxiety symptoms.

    “In terms of anxiety symptoms, step one of the model was not significant. Step two accounted for 30.0% of variance, and Describing (β = −.46, t = −2.77, p < .01) and Nonjudgment (β = −.38, t = −2.79, p < .01) were significant variables.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The associations between mindfulness skills and outcomes are not explained by unmeasured confounding variables beyond age and race.

  • May combine two claims.

    Findingown data

    In regression, the second step for panic symptoms was significant and explained 19.3% of unique variance, but no individual mindfulness skill was significantly associated with panic symptoms.

    “Step two of the model was significant and accounted for 19.3% of unique variance. There were no significant individual variables at step two (Describing; β = .32, t = 1.89, p = .07).”
    Quote in the paperNot a substantial claim
    • Rests on an assumption: The associations between mindfulness skills and outcomes are not explained by unmeasured confounding variables beyond age and race.

  • May combine two claims.

    Interpretationcitation

    The link between Nonjudgment and Nonreactivity and lower depression symptoms is generally consistent with prior community and college samples, suggesting there may be no asthma-specific differences in these associations.

    “This finding is generally consistent with previous work in community and college samples (Cash & Whittingham, 2010; Barnes & Lynn, 2010), suggesting that there may not be differential associations for individuals with asthma.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Cash & Whittingham, 2010 source
    • cites Barnes & Lynn, 2010 source

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

    Study design and conductown data

    The IDAS-Panic subscale had acceptable internal consistency in this sample (α = .79).

    “Internal consistency in the current sample was acceptable (α = .79).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    The Anxiety Sensitivity Index-3 had excellent internal consistency in this sample (α = .92).

    “Internal consistency for the current sample was excellent (α = .92).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Study design and conductreasoning

    The study used only self-report measures, so reporting errors and shared method variance are possible.

    “Second, the current study relied solely on self-report measures. Thus, there is a possibility of reporting errors and shared method variance.”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    The Inventory of Depression and Anxiety Symptoms shows strong convergent, discriminant, criterion, and incremental validity.

    “The IDAS shows strong convergent, discriminant, criterion, and incremental validity (Watson et al., 2008).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Watson et al., 2008 source

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

    Study design and conductown data

    The Five Facet Mindfulness Questionnaire had acceptable to good internal consistency in this sample (α range = .78 - .87).

    “Internal consistency in the current sample was acceptable to good (α range = .78 - .87).”
    Quote in the paperNot a substantial claim

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

    Study design and conductown data

    The DASS-Anxiety subscale had good internal consistency in this sample (α = .88).

    “Internal consistency in the current sample was good (α = .88).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationown data

    People with asthma who can describe and label internal sensations may be less likely to experience general anxiety and possibly panic symptoms, and less likely to fear arousal-related sensations, which could lower risk for anxiety and mood psychopathology.

    “These results suggest that individuals with asthma who are able to describe and label their internal sensations are less likely to experience general anxiety, and possibly panic symptoms, and are less likely to fear of arousal-related sensations, which could decrease the risk for developing anxiety and mood psychopathology.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The cross-sectional associations between mindfulness skills and outcomes reflect a causal direction from mindfulness to outcomes that can be targeted by intervention.

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

    Premisecitation

    Shortened mindfulness-based interventions may be as effective as full-length protocols.

    “In addition, abbreviated mindfulness-based interventions may be just as effective as the full length protocols (Carmody & Baer, 2009), suggesting that these treatments may be easily implemented in clinical settings.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Carmody & Baer, 2009 source

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

    Study design and conductown data

    The Asthma Screening Questionnaire had good internal consistency in this study (α = .81).

    “Internal consistency for the current study was good (α = .81).”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    The Depression Anxiety Stress Scale has shown good convergent and discriminant validity and internal consistency in clinical and non-clinical groups.

    “The DASS has demonstrated good convergent and discriminant validity and internal consistency in both clinical and non-clinical populations (Anthony et al., 1998; Lovibond & Lovibond, 1995).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Anthony et al., 1998

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

    • cites Lovibond & Lovibond, 1995

      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 data

    The Center for Epidemiological Studies Depression Scale had good internal consistency in this sample (α = .87).

    “Internal consistency for the current sample was good (α = .87).”
    Quote in the paperNot a substantial claim

  • May combine two claims.

    Interpretationreasoning

    The findings suggest that mindfulness skills may not improve the physiological symptoms of asthma, but instead may improve how a person reacts to those symptoms and perceives their impact on daily functioning.

    “These findings are partially consistent with those of Pbert et al.’s (2012) study, and suggest that mindfulness skills may not improve the physiological symptoms associated with asthma, but rather improve how one reacts to these symptoms and perceive they are impacting daily functioning.”
    Quote in the paperSubstantial claim
    • Rests on an assumption: The cross-sectional associations between mindfulness skills and outcomes reflect a causal direction from mindfulness to outcomes that can be targeted by intervention.

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

    Premisecitation

    The Asthma Quality of Life Questionnaire has shown good internal consistency and discriminant validity.

    “The AQLQ has demonstrated good internal consistency and discriminant validity (Juniper et al., 1993).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Juniper et al., 1993 source

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

    Study design and conductown data

    The Asthma Control Test had good internal consistency in this sample (α = .86).

    “Internal consistency for the current sample was good (α = .86).”
    Quote in the paperNot a substantial claim

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

    Premisecitation

    The Anxiety Sensitivity Index-3 has the strongest psychometric properties among current measures of anxiety sensitivity.

    “The ASI-3 has demonstrated the strongest psychometric properties of any current measure of anxiety sensitivity (Taylor et al., 2007).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Taylor et al., 2007 source

  • May combine two claims.

    Interpretationown data

    Greater use of Observing is significantly associated with higher anxiety sensitivity, consistent with prior work, suggesting that observing internal experiences without nonjudgmental awareness may be harmful.

    “Greater use of the skill of Observing was significantly associated with higher levels of AS, which is consistent with previous work (Baer et al., 2008; Luberto et al., 2011), and suggests that simply observing internal experiences, without nonjudgmental awareness, may be harmful.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Baer et al., 2008 source
    • cites Luberto et al., 2011 source

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

    Premisecitation

    The Asthma Control Test has good reliability and can distinguish patient groups with different levels of asthma control.

    “The ACT shows good reliability and is able to discriminate between groups of patients with different levels of asthma control (Nathan et al., 2004).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nathan et al., 2004 source

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

    Premisecitation

    A breath carbon monoxide cutoff of 5 ppm is optimal for reliably identifying non-smoking status.

    “Research indicates that 5 ppm is an optimal cutoff score for reliably discriminating non-smoking status (Perkins, Karelitz, & Jao, 2013).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Perkins, Karelitz, & Jao, 2013

      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 data

    The Asthma Quality of Life Questionnaire had excellent internal consistency in this sample (α = .97).

    “Internal consistency for the current sample was excellent (α = .97).”
    Quote in the paperNot a substantial claim
31 of 31

  • The paper relies on this without support.

    The cross-sectional associations between mindfulness skills and outcomes reflect a causal direction from mindfulness to outcomes that can be targeted by intervention.

    “These findings suggest that it may be useful to target the mindfulness skills of describing, nonjudgment, and nonreactivity among individuals with asthma, particularly those with elevated levels of anxiety and depression, in order to improve psychological and asthma-related outcomes.”

  • The paper relies on this without support.

    The associations between mindfulness skills and outcomes are not explained by unmeasured confounding variables beyond age and race.

    “Results indicated that, after controlling for the effects of race and age, greater ability to describe present moment experiences was significantly associated with better asthma-related quality of life and lower levels of anxiety symptoms.”
2 of 2

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 says Observing was associated with lower anxiety sensitivity, results say higher anxiety sensitivity

    Major

    The abstract reports a negative association for Observing and anxiety sensitivity, but the Results section states the opposite direction. These statements cannot both be true as written.

  • Observing has opposite reported associations with anxiety sensitivity

    Major

    The abstract says greater Observing is linked to lower anxiety sensitivity, while the discussion says it is linked to higher anxiety sensitivity.

2 of 2

Cites

Flagged first, then by citations

Research works printed but not linked: 2

  1. 10.1177/014662167700100306 · DOI · Paper page
  2. Shin B., 2010, Journal of Investigational Allergology Clinical Immunology, 20, 27

Cited by

Sorted by citations

Related

Authors
Kraemer, K. M., & McLeish, A.
Affiliations
  • Beth Israel Deaconess Medical Center (US)
  • University of Louisville (US)
Corresponding author
McLeish, Alison
ORCID
Venue
Psychology, Health & Medicine
Publisher
Informa UK Limited
Published
2018-10-04
Volume
24
Issue
2
Pages
155-166
ISSN
  • 1354-8506 (ISSN-L)
  • 1465-3966
DOI
10.1080/13548506.2018.1529326
PMC
PMC6741348
OpenAlex
W2895363778
Cited by
7
References
55
Citations by year
2025: 2 · 2021: 1 · 2020: 2 · 2019: 2
FWCI
1.47
Type
journal article
Language
en
Open access
Locations
  • Psychology Health & Medicine (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
Funders
University of Cincinnati Leadership Empowerment Advancement for Women STEM Faculty (UC LEAF)
Topics
  • Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
  • Health Sciences › Medicine › Physiology › Asthma and respiratory diseases
  • Social Sciences › Psychology › Experimental and Cognitive Psychology › Anxiety, Depression, Psychometrics, Treatment, Cognitive Processes
Keywords
mindfulness, asthma, asthma control, asthma quality of life, depressive symptoms, anxiety symptoms, anxiety sensitivity, panic symptoms, non-judgment, non-reactivity, present-moment awareness, psychological outcomes
MeSH terms
Adolescent, Adult, Aged, Anxiety, Asthma, Depression, Female, Humans, Male, Middle Aged, Quality of Life, Comorbidity, Outcome Assessment, Health Care, Young Adult, Mindfulness

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