Interpretation Bias Mediates the Effect of Mindfulness and Acceptance on Anxiety and Depression
By John M. de Castro, Ph.D.
“Anxiety softens when we can create a space between ourselves and what we’re experiencing. When you react in ways that aren’t mindful, they can gradually grow into habits that are detrimental to your health and well-being.” – Mindful
Anxiety disorders are the most common mental illness in the United States, affecting 40 million adults, or 18% of the population. A characterizing feature of anxiety disorders is that the sufferer overly identifies with and personalizes their thoughts. The sufferer has recurring thoughts, such as impending disaster, that they may realize are unreasonable, but are unable to shake. This may indicate that treating the cognitive processes that underlie the anxiety may be an effective treatment. Indeed, Mindfulness practices have been shown to be quite effective in altering cognitive processes and relieving anxiety.
Depression is the most common mental illness, affecting over 6% of the population. Depression can be difficult to treat and is usually treated with anti-depressive medication. But drugs often have troubling side effects and can lose effectiveness over time. In addition, many patients who achieve remission have relapses and recurrences of the depression. Fortunately, Mindfulness training is also effective for treating depression.
A cognitive tendency that can exacerbate anxiety and depression is interpretation bias. This is a tendency to interpret situations in a negative way even when the situation is ambiguous. This can lead to interpreting even neutral situations as threatening. An alternative explanation for the effectiveness of mindfulness training for anxiety and depression is that it may reduce interpretation bias, making it less likely that situations would be interpreted as threatening and thereby lowering anxiety and depression.
In today’s Research News article “Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6320741/ ), Mayer and colleagues performed 2 studies to examine the relationships of mindfulness, anxiety, depression, and interpretation bias.
In the first study they recruited college students and had them complete online questionnaires and psychometric tests measuring mindfulness, anxiety, depression, and interpretation bias. The variables were then subjected to regression analysis. They found that the higher the level of mindfulness the lower the levels of depression, anxiety, and interpretation bias. They further found that the mindfulness association with reduced anxiety and depression was in part the result of mindfulness’ association with reduced interpretation bias. Mindfulness was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.
In the second study they recruited a community sample of adults with mixed ages and had them complete online questionnaires measuring mindfulness, anxiety, depression, interpretation bias, and acceptance of internal sensations. They found similar results for acceptance as they found in study 1 for mindfulness, with the higher the level of acceptance the lower the levels of depression, anxiety, and interpretation bias. Also similar to study 1 they found that the association of acceptance with reduced anxiety and depression was in part the result of acceptance’ association with reduced interpretation bias. Acceptance was both directly associated with lower anxiety and depression and indirectly by being associated with lower levels of interpretation bias which, in turn, was associated with lower anxiety and depression.
These are interesting findings but they are correlational. So, no clear conclusions regarding causation can be reached. Previous research, however, has clearly shown a causal connection between mindfulness and acceptance and anxiety and depression. This suggests that the relationships observed in the current study as due to mindfulness and acceptance causing the relief of anxiety and depression.
The results suggest that the associations of both mindfulness and acceptance of internal states are associated with lower levels of both anxiety and depression and that these associations are in part due to direct associations with anxiety and depression and also indirect associations involving both mindfulness and acceptance being associated with lower levels of interpretation bias that, in turn, is associated with lower levels of anxiety and depression. This suggests that mindfulness and acceptance, in part, affect anxiety and depression by altering the cognitive interpretation of situations, lowering the tendency to interpret situations as threatening and thereby lowering the anxiety and depression that results from threatening interpretations.
So, interpretation bias mediates the effect of mindfulness and acceptance on anxiety and depression.
“Mindfulness keeps us focused on the present, and helps us meet challenges head on while we appreciate all our senses absorb. On the contrary, focus on the future contributes to anxiety, while perseveration on the past feeds depression.” – Vincent Fitzgerald
CMCS – Center for Mindfulness and Contemplative Studies
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Mayer, B., Polak, M. G., & Remmerswaal, D. (2018). Mindfulness, Interpretation Bias, and Levels of Anxiety and Depression: Two Mediation Studies. Mindfulness, 10(1), 55-65.
In two studies, a possible mediation effect was tested of cognitive interpretation bias in the relation between respectively dispositional mindfulness and acceptance, on the one hand, and symptoms of depression and anxiety, on the other hand. An undergraduate student sample (N = 133; 86% female, Mage = 19.8) and a convenience community sample (N = 186; 66% female, Mage = 36.5) were examined by means of an online questionnaire measuring dispositional mindfulness (FFMQ-SF; Study 1) and acceptance (AAQ-II; Study 2), anxiety (STAI-trait) and depressive (BDI-II) symptoms, and interpretation bias (with the interpretation bias task, IBT). Considering both studies, results showed consistently the expected relations of larger mindfulness skills going together with a smaller cognitive interpretation bias and lower levels of depression and anxiety symptoms. More interestingly, it was found that interpretation bias served as a mediator in the relations between respectively dispositional mindfulness and acceptance, and symptoms of depression and anxiety. With these findings, some more insight in the working mechanisms of mindfulness-based treatments on internalizing psychopathology has been obtained.