Mindfulness Meditation Targets Transdiagnostic Symptoms Implicated in Stress-Related Disorders: Understanding Relationships between Changes in Mindfulness, Sleep Quality, and Physical Symptoms

Abstract

Mindfulness-Based Stress Reduction (MBSR) is an 8-week meditation program known to improve anxiety, depression, and psychological well-being. Other health-related effects, such as sleep quality, are less well established, as are the psychological processes associated with therapeutic change. This prospective, observational study (n = 213) aimed to determine whether perseverative cognition, indicated by rumination and intrusive thoughts, and emotion regulation, measured by avoidance, thought suppression, emotion suppression, and cognitive reappraisal, partly accounted for the hypothesized relationship between changes in mindfulness and two health-related outcomes: sleep quality and stress-related physical symptoms. As expected, increased mindfulness following the MBSR program was directly correlated with decreased sleep disturbance (r = -0.21, p = 0.004) and decreased stress-related physical symptoms (r = -0.38, p < 0.001). Partial correlations revealed that pre-post changes in rumination, unwanted intrusive thoughts, thought suppression, experiential avoidance, emotion suppression, and cognitive reappraisal each uniquely accounted for up to 32% of the correlation between the change in mindfulness and change in sleep disturbance and up to 30% of the correlation between the change in mindfulness and change in stress-related physical symptoms. Results suggest that the stress-reducing effects of MBSR are due, in part, to improvements in perseverative cognition and emotion regulation, two "transdiagnostic" mental processes that cut across stress-related disorders.

Figure 1

Conceptual model showing hypothesized mechanisms of mindfulness involved in MBSR. Specifically, increased mindfulness is linked to reduced cognitive perseveration (e.g., lower rumination, fewer unwanted intrusive thoughts) and enhanced emotion regulation (e.g., greater cognitive reappraisal, less emotion suppression, less thought suppression, and less avoidance) that, together, may partly explain improved sleep quality and stress-related physical symptoms, both of which are linked to cardiovascular disease (CVD) risk and other chronic health conditions. Adapted from J. M. Greeson (PI) NIH grant application K99AT004945. “Mechanisms of Mindfulness: Effects on Sleep Quality, Stress Physiology & CVD Risk.”