Mindful attention awareness and cognitive defusion are indirectly associated with less PTSD-like symptoms via reduced maladaptive posttraumatic cognitions and avoidance coping

Abstract

Recently, the effects of mindfulness-based interventions for posttraumatic stress disorder (PTSD) have been studied. However, we lack knowledge of the processes or mechanisms through which mindfulness influences resilience or promotes recovery following exposure to trauma. In this study, we examine the process by which mindfulness and cognitive-behavioral factors such as posttraumatic negative cognition and avoidance behaviors are associated with reduced PTSD-like symptoms. A questionnaire survey was conducted with 885 university students, using the Trauma Experience Questionnaire, Mindful Attention Awareness Scale, Cognitive Fusion Questionnaire, Post-Traumatic Stress Disorder Checklist, revised Ways of Coping Checklist, and a brief version of the Posttraumatic Cognitions Inventory. Data from 254 participants who experienced trauma with PTSD-like symptoms were analyzed. The final model using SEM indicated no direct association of mindful attention awareness on PTSD-like symptoms, a small direct association of cognitive defusion on PTSD-like symptoms, and a large indirect association mediated by posttraumatic negative cognitions and avoidance coping. Owing to the study’s cross-sectional design, strong conclusions cannot be drawn regarding the causal relationship of mindfulness and cognitive-behavioral factors or generalizations. However, our findings suggest that it would be worthwhile to continue to clarify the mechanism of mindfulness and to investigate its use in the treatment of PTSD. In the future, a highly accurate study design will hopefully be used to examine the mechanisms of several different factors associated with improvement in posttraumatic stress symptoms, preferably including them in the same model.

Developing a mechanism-based therapy for acute psychiatric inpatients with psychotic symptoms: an Intervention Mapping approach

“…Furthermore, we aimed to reduce patients’ reactivity to aversive internal experiences via promoting cognitive defusion , which is determined by functional metacognitive goals and strategies . Cognitive defusion has been found to generally improve functioning, reduce dysfunctional attitudes, anxiety, negative affect ( 102 ) and also post-traumatic-like symptoms ( 129 ) and sleep difficulties ( 130 ). It has also been found to mediate symptom distress in psychosis via reduced believability of thought and voice content ( 131 ), and changes in metacognitive beliefs and coping skills ( 18 ).…”