Investigating the Role of Interpretation Bias in Mindfulness-Based Treatment of Adults With Generalized Anxiety Disorder

Abstract

Although mindfulness-based interventions (MBIs) have garnered empirical support for a wide range of psychological conditions, the psychological processes that mediate the relationship between MBIs and subsequent symptomatic improvement are less well-understood. In the present study we sought to examine, for the first time, the relationship between mindfulness, negative interpretation bias as measured by the homophone task, and anxiety among adults with Generalized Anxiety Disorder (GAD). Forty-two individuals with GAD completed measures of mindfulness, interpretation bias, and anxiety before and after treatment with Mindfulness-based Stress Reduction (MBSR). Contrary to prior research, we did not find evidence of an indirect relationship between baseline levels of mindfulness and anxiety via negative interpretation bias. MBSR did result in significant reductions in negative interpretation bias from baseline to post-treatment; however, we did not find evidence of an indirect relationship between changes in mindfulness and changes in anxiety via changes in interpretation bias. Taken together, these results provide minimal support for the hypothesized relationship between mindfulness, negative interpretation bias, and anxiety among adults with GAD. Limitations and specific suggestions for further inquiry are discussed.

For there is nothing either good or bad: a study of the mediating effect of interpretation bias on the association between mindfulness and reduced post-traumatic stress vulnerability

“…The low and statistically non-significant association between trait mindfulness and interpretation bias found in the present study was contrary to the theoretical links between these constructs [ 36 – 38 ] and a prior study that documented an association between higher levels of trait mindfulness and lower levels of interpretation bias [ 41 ]. It was, however, consistent with another study that did not replicate this association [ 39 ]. The differing results of Mayer et al [ 41 ], Hoge et al [ 39 ], and the current study may point to a difference in the relationship between trait mindfulness and interpretation bias in different populations.…”

“…It was, however, consistent with another study that did not replicate this association [ 39 ]. The differing results of Mayer et al [ 41 ], Hoge et al [ 39 ], and the current study may point to a difference in the relationship between trait mindfulness and interpretation bias in different populations. Specifically, it could be that higher levels of trait mindfulness are associated with lower levels of interpretation bias in general populations, such as that sampled by Mayer et al [ 41 ], but not in those experiencing significant mental health problems, such as that sampled by Hoge et al [ 39 ], nor in those who have been exposed to one or more potentially traumatic events, such as that examined in the current study.…”

“…Interpretation bias is also theoretically linked to mindfulness, given mindfulness involves applying a nonjudgmental lens to one’s present moment experience and is theorised to produce more veridical perceptions of external and internal events that are less influenced by prior beliefs and learned associations [ 36 – 38 ]. Though empirical research into the potential links between mindfulness and interpretation bias is still in its infancy, studies have demonstrated a negative association between mindfulness and interpretation bias (e.g., [ 39 – 41 ]). Two of these studies also examined the extent to which interpretation bias might mediate the association between trait mindfulness and symptoms of psychopathology.…”

“…While promising, this pattern of results has not been found consistently. Hoge et al [ 39 ] measured the association between trait mindfulness, interpretation bias and symptoms of Generalised Anxiety Disorder (GAD) before and after an eight-week Mindfulness-based Stress Reduction intervention. Contrary to Mayer et al [ 41 ], Hoge et al [ 39 ] did not find an association between baseline levels of trait mindfulness and interpretation bias.…”

“…Hoge et al [ 39 ] measured the association between trait mindfulness, interpretation bias and symptoms of Generalised Anxiety Disorder (GAD) before and after an eight-week Mindfulness-based Stress Reduction intervention. Contrary to Mayer et al [ 41 ], Hoge et al [ 39 ] did not find an association between baseline levels of trait mindfulness and interpretation bias. Additionally, although the mindfulness intervention increased levels of trait mindfulness, decreased interpretation bias, and decreased symptoms of GAD, they did not find evidence of interpretation bias mediating the association between changes in trait mindfulness and symptoms of GAD.…”