Mediators of Mindfulness-Based Stress Reduction (MBSR): assessing the timing and sequence of change in cancer patients

J Clin Psychol. 2015 Jan;71(1):21-40. doi: 10.1002/jclp.22117. Epub 2014 Aug 5.


Objectives: This waitlist-controlled study examined the timing of changes during Mindfulness-Based Cancer Recovery (MBCR), and explored sequential mediated effects through enhanced mindfulness and emotion regulation (ER) in a cancer population.

Method: Patients were recruited from the MBCR program waitlist and were either registered for immediate participation (n = 135) or waiting for the next program to begin (n = 76). Participants completed self-report measures of stress symptoms, mood disturbance, mindfulness, and ER (rumination, worry, and experiential avoidance) pre-, mid- and post-MBCR or waiting period.

Results: There was a relatively early effect of MBCR on observing, nonjudging, rumination, and worry. All other measures changed later. Early changes in present-focused nonjudgmental awareness, rumination, and worry mediated the effect of MBCR on mindfulness skills such as nonreactivity later on.

Conclusion: The constructs of mindfulness and ER may overlap and changes may be mutually facilitative during MBCR. The study informs our understanding of mindfulness and ER as mechanisms of mindfulness-based interventions.

Keywords: cancer; mindfulness; meditation; emotion regulation; mechanisms.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Cancer Care Facilities
  • Emotions
  • Female
  • Humans
  • Linear Models
  • Longitudinal Studies
  • Male
  • Meditation* / methods
  • Meditation* / psychology
  • Middle Aged
  • Mindfulness / methods*
  • Neoplasms / psychology*
  • Self Report
  • Stress, Psychological / therapy*
  • Treatment Outcome
  • Waiting Lists