David H. Klemanski

Mindfulness and emotion regulation in depression and anxiety: common and distinct mechanisms of action.

The current study seeks to investigate the mechanisms through which mindfulness is related to mental health in a clinical sample of adults by examining (1) whether specific cognitive emotion regulation strategies (rumination, reappraisal, worry, and nonacceptance) mediate associations between mindfulness and depression and anxiety, respectively, and (2) whether these emotion regulation strategies operate uniquely or transdiagnostically in relation to depression and anxiety.

Mapping Mindfulness Facets Onto Dimensions of Anxiety and Depression

Mindfulness has been associated with anxiety and depression, but the ways in which specific facets of mindfulness relate to symptoms of anxiety and depression remains unclear. The purpose of the current study was to investigate associations between specific facets of mindfulness (e.g., observing, describing, nonjudging, acting with awareness, and nonreactivity) and dimensions of anxiety and depression symptoms (e.g., anxious arousal, general distress-anxiety, general distress-depression, and anhedonic depression) while controlling for shared variance among variables. Participants were 187 treatment-seeking adults. Mindfulness was measured using the Five Facet Mindfulness Questionnaire and symptoms of depression and anxiety were measured using the Mood and Anxiety Symptom Questionnaire. Bivariate correlations showed that all facets of mindfulness were significantly related to all dimensions of anxiety and depression, with two exceptions: describing was unrelated to general distress-anxiety, and observing was unrelated to all symptom clusters. Path analysis was used to simultaneously examine associations between mindfulness facets and depression and anxiety symptoms. Significant and marginally significant pathways were retained to construct a more parsimonious model and model fit indices were examined. The parsimonious model indicated that nonreactivity was significantly inversely associated with general distress anxiety symptoms. Describing was significantly inversely associated with anxious arousal, while observing was significantly positively associated with it. Nonjudging and nonreactivity were significantly inversely related to general distress-depression and anhedonic depression symptomatology. Acting with awareness was not significantly associated with any dimensions of anxiety or depression. Findings support associations between specific facets of mindfulness and dimensions of anxiety and depression and highlight the potential utility of targeting these specific aspects of mindfulness in interventions for anxiety and mood disorders.

Observing nonreactively: a conditional process model linking mindfulness facets, cognitive emotion regulation strategies, and depression and anxiety symptoms.

BACKGROUND Mindfulness-based interventions for depression and anxiety emphasize the importance of observing present moment experience, but observing has often been positively related to anxiety and unrelated to depression symptoms. The current study sought to better understand the conditions and mechanism through which observing relates to symptoms by examining six conditional process models in which (1) nonreactivity moderates the direct effect of observing on symptoms of anxiety and depression symptoms and (2) nonreactivity moderates the indirect effect of observing on anxiety and depression via cognitive emotion regulation strategies (i.e., rumination, worry, and reappraisal). METHODS A clinical sample of 189 adults with anxiety and depressive disorders completed the Five Facet Mindfulness Questionnaire, Mood and Anxiety Symptom Questionnaire, Penn State Worry Questionnaire, Ruminative Responses Scale, and Emotion Regulation Questionnaire. RESULTS Conditional process models showed that nonreactivity significantly moderated the direct effect of observing on symptoms of depression, but not anxiety. Additionally, nonreactivity significantly moderated the indirect effect of observing on symptoms of depression through rumination and reappraisal, but not worry. For anxiety, nonreactivity significantly moderated the indirect effect of observing on symptoms through worry and rumination, but not reappraisal. LIMITATIONS Causal interpretations of results are limited. CONCLUSION Findings suggest that the relationship between observing and symptoms of depression and anxiety depends on the capacity to observe nonreactively, which may influence symptoms directly and indirectly through cognitive emotion regulation strategies. Findings raise important implications for tailoring mindfulness-based treatments for anxiety and depression symptoms.

Borderline Personality Features and Harmful Dysregulated Behavior: The Mediational Effect of Mindfulness

OBJECTIVES The current preliminary study investigated whether deficits in mindfulness (awareness, attentiveness, and acceptance of the present experience) may underlie the relationship of borderline personality disorder (BPD) features to self-injury and overall acts of harmful dysregulated behavior. METHOD Nonparametric bootstrapping procedures were used to examine theoretical relationships among variables in a psychiatric sample of adults (N = 70). Participants were asked to imagine themselves in distress-inducing situations and then write what they would actually do to decrease distress in such situations. RESULTS As hypothesized, mindfulness statistically mediated the relationship of BPD features to reported acts of (a) self-injury and (b) overall harmful dysregulated behaviors. CONCLUSIONS Difficulties in the ability to be aware, attentive, and accepting of ongoing experience may play a role in the relationship of BPD features to harmful dysregulated behaviors. Future research should clarify potential reciprocal effects between BPD features and mindfulness with prospective, multioccasion designs.

Emotion-related regulatory difficulties contribute to negative psychological outcomes in active-duty Iraq war soldiers with and without posttraumatic stress disorder

Data suggest military personnel involved in U.S. military initiatives in Iraq and Afghanistan are returning from deployment with elevated rates of mental health diagnoses, including posttraumatic stress disorder (PTSD). The aim of this study was to examine difficulties with emotion regulation as a potential contributory mechanism by which soldiers have poorer psychological outcomes, such as depression, dissociation, alcohol abuse, and interpersonal difficulties. Participants were 44 active‐duty male service members who comprised three groups, including those deployed with and without diagnosed PTSD and those prior to deployment. Participants in the PTSD group scored significantly higher on measures of self‐reported depression, trauma‐related dissociation, alcohol misuse, and social adjustment difficulties than did comparison groups. Importantly, difficulties with emotion regulation were found to partially mediate the relationship between PTSD and depression, poor social adjustment, and trauma‐related depersonalization but not alcohol misuse. Emotion‐regulation difficulties are important to consider in the relationship between PTSD and additional psychological outcomes in recently deployed personnel. Implications for treatment are briefly discussed.

Teasing apart low mindfulness: differentiating deficits in mindfulness and in psychological flexibility in predicting symptoms of generalized anxiety disorder and depression.

BACKGROUND This research investigated the differential ability of three components of low mindfulness to uniquely predict symptoms of generalized anxiety disorder (GAD) and depression, while controlling for psychological inflexibility, a construct conceptually related to low mindfulness. Also examined was the meditational role of several mindfulness facets in the relationship between psychological inflexibility and symptoms of each disorder. METHODS Using a clinical sample (n=153) containing mostly patients with GAD or depression diagnoses, we conducted hierarchical multiple regression analyses and mediation analyses to determine unique relationships. RESULTS Whereas deficits in adopting a non-reactive perspective exhibited incremental validity beyond psychological inflexibility in predicting symptoms of GAD, deficits in acting with awareness did so in predicting symptoms of depression. Results of mediation analyses corroborated this pattern, as the relationships psychological inflexibility exhibited with symptoms of GAD and of depression were mediated by non-reactivity and acting with awareness, respectively. LIMITATIONS The cross-sectional design of this study precludes causal interpretations of the mediation models. CONCLUSION Findings corroborate the following conclusions: (i) the lack of present oriented awareness experienced by individuals with symptoms of depression is not completely accounted for by psychological inflexibility nor by symptoms of GAD; (ii) the reactive approach to automatic thoughts adopted by those with symptoms of GAD is not completely accounted for by psychological inflexibility nor by symptoms of depression. These conclusions suggest that it would be profitable for mindfulness-based therapies to concentrate on these specific mindfulness deficits to ameliorate the severity of GAD and depression.

Taxonicity and network structure of generalized anxiety disorder and major depressive disorder: An admixture analysis and complex network analysis.

BACKGROUND Recent years have witnessed sustained efforts to delineate the nosology of generalized anxiety disorder (GAD), especially in light of its substantial comorbidity with major depressive disorder (MDD). Traditional diagnostic conceptualizations regard these disorders as categorically distinct; however, extant literature attests to appreciable similarities. The application of admixture analyses and complex network analyses has become more prevalent in recent years to investigate the presence of meaningful subgroups in mental disorders and to address qualitative similarity in network structure across disorders. To date, no studies have extended these analytic techniques to determine whether GAD and MDD constitute independent syndromes. The current study used a clinical sample comprising individuals diagnosed with primary GAD or primary MDD to examine potential subgroups and network structure using symptoms of each disorder as indicators. METHODS The current sample comprised 111 individuals who received primary diagnoses of either GAD or MDD and completed a battery of assessments related to anxiety and depression. RESULTS Results of the admixture analyses converged on a single class solution, suggesting that individuals with GAD derive from the same population as those with MDD. Furthermore, results of the complex network analyses did not reveal differences in centrality parameters across disorders, suggesting qualitative similarity. LIMITATIONS The cross-sectional nature of this study precludes conclusions about the temporal and causal dynamics of these disorders CONCLUSION GAD and MDD exhibit robust similarities, as evidenced by the converging results of the admixture analyses and complex network analyses. This conclusion complements the findings of transdiagnostic research, which has identified common mechanisms underlying multiple emotional disorders.