It's not what you think, it's how you relate to it: dispositional mindfulness moderates the relationship between psychological distress and the cortisol awakening response

Psychoneuroendocrinology. 2014 Oct:48:11-8. doi: 10.1016/j.psyneuen.2014.05.012. Epub 2014 May 27.


Objective: The cortisol awakening response (CAR) is a natural metabolic response that can be potentiated by negative cognitive-emotional processes, including stress appraisals, negative affect, and rumination. Psychological distress and the CAR are not consistently related, however. Individual differences in aspects of dispositional mindfulness which reflect how people relate to negative thoughts and emotions may help explain such inconsistencies. We tested whether the tendency to (1) label and describe inner experiences and (2) accept negative thoughts and feelings without judgment moderated the association between psychological distress and the CAR.

Methods: Self-reported dispositional mindfulness, perceived stress, anxiety, negative affect, rumination, and the CAR were assessed among overweight/obese women. Regression analyses were conducted to examine whether dispositional mindfulness moderated the relationship between indicators of psychological distress and the CAR.

Results: While psychological distress was consistently positively related to the CAR, these associations were qualified by significant interactions with both components of dispositional mindfulness. Psychological distress was associated with the CAR at lower levels of dispositional mindfulness but not at higher levels.

Conclusion: These findings are consistent with the idea that the tendency to describe and accept experiences may buffer the impact of psychological distress on physiological arousal. These metacognitive processes may be important moderators in unraveling the complex relationship between psychological distress and physiological stress reactivity. Further research is recommended to replicate this approach in other populations.

Keywords: Acceptance; Cortisol; Cortisol awakening response; Dispositional mindfulness; Meditation; Negative affect; Perceived stress; Rumination.

Publication types

  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adaptation, Psychological / physiology
  • Anxiety / metabolism
  • Arousal / physiology*
  • Female
  • Humans
  • Hydrocortisone / metabolism*
  • Mindfulness*
  • Perception
  • Personality / physiology*
  • Saliva / chemistry
  • Saliva / metabolism
  • Stress, Psychological / metabolism*
  • Surveys and Questionnaires
  • Thinking / physiology*


  • Hydrocortisone