Positive Reappraisal Coping Mediates the Stress-Reductive Effects of Mindfulness: An Upward Spiral of Resilience

Background: Mindfulness-based interventions have become increasingly well-regarded for their demonstrated therapeutic efficacy across a broad range of stress-related conditions. Yet, little is known about the mechanisms underlying the salutary effects of mindfulness on stress. To the extent that mindfulness practice reduces stress, it may do so by inducing a broadened attentional state, which in turn may lead to generative and flexible cognitive styles such as positive reappraisal, i.e., the adaptive process through which stressful events are re-construed as benign, beneficial, and meaningful. This coping strategy (alternately conceptualized as benefit-finding) is associated with reduced distress and improved mental and physical health outcomes. We hypothesize that, independent of the effects of mindfulness practice on negative cognitive processes, such training may engender a mindful disposition that facilitates the generation of positive reappraisals in the face of acute and chronic stressors, thereby undoing the stress reaction and its consequences.

Methods: 215 men and women suffering from a wide range of stress-related conditions participated in and 199 completed an eight week, mindfulness-based stress and pain management program (MSPM) offered at University of North Carolina - Chapel Hill Memorial Hospital. Participants completed self-report measures of mindfulness, cognitive coping styles, and perceived stress pre (T1) and post (T2) the MPSM course. Complete T1 and T2 data were available for 120 individuals, and missing data was imputed or estimated for subsequent analyses. Hierarchical regression analyses were used to test whether mindfulness and positive reappraisal mutually and serially promote one another. Path analyses were used to ascertain the direct and indirect effects of changes in mindfulness, positive reappraisal, and catastrophizing on changes in perceived stress.

Results: Participants completing MSPM experienced significant increases in dispositional mindfulness and positive reappraisal coping, as well as significant reductions in perceived stress and catastrophizing. Controlling for T1 positive reappraisal, changes in mindfulness predicted T2 positive reappraisal, while controlling for T1 mindfulness, changes in positive reappraisal coping predicted T2 mindfulness. In addition, the effect of mindfulness on perceived stress was partially mediated by increases in positive reappraisal but not by changes in catastrophizing.

Conclusions and Implications: Increases in mindfulness predicted growth in positive reappraisal, while increases in positive reappraisal predicted growth in mindfulness. Positive reappraisal and mindfulness appear to mutually and reciprocally enhance one another. Thus, increases in one's ability to mindfully decenter from stress appraisals into the mode of mindfulness may promote positive reappraisal coping over time. Similarly, increasingly making positive interpretations of stressful life events appears to enhance mindful dispositionality. Through the practice of mindfulness, individuals appear to engender a broadened state of awareness that facilitates empowering interpretations of stressful life events, leading to substantially reduced distress. In so doing, one may learn to find benefit in life challenges or re-construe them as meaningful opportunities for personal growth. This salutary process has clear implications for the development of interventions designed to bolster the resilience of vulnerable persons.