Reduce the Association of Anxiety with Psychological Well-Being During Stress with Mindfulness
By John M. de Castro, Ph.D.
“in medical students. . . mindfulness meditation may be used to elicit positive emotions, minimize negative affect and rumination, and enable effective emotion regulation.” – Michael Minichiello
In the modern world education is a key for success. There is a lot of pressure on medical students to excel. This stress might in fact be counterproductive as the increased pressure can lead to stress and anxiety which can impede the student’s physical and mental health, well-being, and performance in medical school. It is, for the most part, beyond the ability of the individual to change the environment to reduce stress, so it is important that methods be found to reduce the students’ responses to stress; to make them more resilient when high levels of stress occur.
Contemplative practices including meditation, mindfulness training, and yoga practice have been shown to reduce the psychological and physiological responses to stress. Indeed, these practices have been found to reduce stress and improve psychological health in students. So, it would seem important to examine the relationship of mindfulness with the psychological well-being of medical students during high pressure periods.
In today’s Research News article “Specific mindfulness traits protect against negative effects of trait anxiety on medical student wellbeing during high-pressure periods.” (See summary below or view the full text of the study at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8338863/ ) Fino and colleagues recruited second year students in medical school and had them complete measures at the beginning and end an academic semester of mindfulness, anxiety, perceived stress, psychosomatic symptoms, and sleep quality.
They found that over the course of the semester there were significant increases in perceived stress and psychosomatic symptoms. In general, the well-being of female students was significantly poorer than that of male students. Mediation analysis revealed that the higher the levels of anxiety at the beginning of the semester the higher the levels of perceived stress and psychosomatic symptoms at the end of the semester. But these relationships were tempered by mindfulness such that the higher the levels of mindfulness the smaller the association between levels of anxiety at the beginning of the semester the higher the levels of perceived stress and psychosomatic symptoms at the end of the semester. This was particularly true for the nonjudging of inner experience facet of mindfulness and to a lesser extent the acting with awareness facet.
These results suggest that over the course of an academic semester in medical school there is a deterioration in the psychological well-being of the students. This is not surprising as the exams at the end of the semester are very stressful. This deterioration is exacerbated by the overall anxiety levels of the students. Again, this is not surprising as anxious students would be expected to react more strongly to the pressures at the end of the semester. What is new is that mindfulness tends to mitigate this effect of anxiety. The more mindful students had less of a deterioration in their well-being resulting from their anxiety level.
Previous research has demonstrated that mindfulness reduces perceived stress, anxiety, and psychosomatic symptoms. So, the mitigating effect of mindfulness was not surprising. But it is interesting that the greatest mitigation was found for the nonjudging of inner experience facet of mindfulness. In other word, accepting the feelings of anxiety as they are, mitigates its impact on psychological well-being. Conversely, judging these feelings multiples their effects on well-being. So, accepting, without judgement, that one is anxious, make that anxiety less impactful on one’s well-being.
So, reduce the association of anxiety with psychological well-being during stress with mindfulness.
“[Mindfulness] training for medical students was associated with increased measures of psychological well-being and self-compassion, as well as improvements in stress, psychological distress and mood.” – Emma Polle
CMCS – Center for Mindfulness and Contemplative Studies
This and other Contemplative Studies posts are available on Twitter @MindfulResearch
Fino, E., Martoni, M., & Russo, P. M. (2021). Specific mindfulness traits protect against negative effects of trait anxiety on medical student wellbeing during high-pressure periods. Advances in health sciences education : theory and practice, 26(3), 1095–1111. https://doi.org/10.1007/s10459-021-10039-w
Medical education is highly demanding and evidence shows that medical students are three times more susceptible to deteriorating physical and mental health than the average college student. While trait anxiety may further increase such risk, little is known about the role of trait mindfulness in mitigating these effects. Here we examine the protective role of specific mindfulness facets as mediators in pathways from trait anxiety to perceived stress, psychosomatic burden and sleep-wake quality in medical students, across repeated measurements throughout the first trimester of the school year. Preclinical medical students enrolled in the second year of the Medical School of University of Bologna completed self-report questionnaires examining personality traits as well as physical and psychological wellbeing. Data unibo were collected at the beginning (Time 1: N = 349) and the end of the first trimester (Time 2: N = 305). As students approached the end of the trimester and upcoming exams, reported levels of perceived stress, psychosomatic problems and difficulties in wakefulness increased significantly compared to the beginning of the trimester. Mediation results showed that trait anxiety predicted such outcomes whereas the protective role of mindfulness facets in mitigating these effects was significant only at Time 2. Specific facets of Nonjudging of inner experience and Acting with awareness proved to be the most effective mediators. Findings highlight that the beneficial role of mindfulness facets in mitigating negative consequences of trait anxiety on medical student wellbeing is revealed in high-pressure periods and when self-regulation is needed the most. Cultivating awareness and nonjudgmental acceptance of one’s inner experiences is a crucial self-regulation resource that can help medical students sustain their wellbeing as they learn and throughout their high-pressure education and professional careers.