City Research Online

Abstract

A surfeit of clinical studies validates the salutary effects of mindfulness training, yet our knowledge of change mechanisms and corresponding biomarkers remain poorly understood. To address these gaps, this doctoral study investigated psychological and psychophysiological processes underpinning mindfulness-induced emotion regulation and mental health, responding to calls for NIH-defined Stage 3 community efficacy trials and pragmatic real-world process evaluation research. Novel exploration was undertaken of the mediational influences of interoceptive (bodily) awareness, acceptance and attention, alongside objective psychophysiological biomarkers including skin conductance responses and cardioceptive interoceptive accuracy.

In line with the Mindfulness Based Stress Reduction (MBSR) literature, the mindfulness condition reported significant improvements across all primary outcomes (stress, distress and anxiety), as well as secondary outcomes of mindfulness and interoceptive awareness skills. Promising evidence emerged that mindfulness promotes emotion regulation via an objective implicit biomarker. The MBSR group demonstrated a small but significant reduction in sympathetic arousal during an emotion-eliciting behavioural task, while the control group trended toward increased arousal, suggesting enhanced implicit emotional regulation. While interoceptive accuracy via heartbeat counting was not improved, significant enhancement of interoceptive metacognition was found, contributing to previous findings that heartbeat counting may not adequately capture adaptive interoceptive awareness cultivated through mind-body therapies.

Multiple mediation analyses revealed that acceptance uniquely mediated distress attenuation, outperforming attention, while both processes independently mediated stress reduction. Neither uniquely mediated anxiety. Global mindfulness skills overrode global interoceptive awareness in mediating primary mental health outcomes, though interoceptive awareness uniquely mediated alexithymia reduction, suggesting that alexithymia may represent a transdiagnostic marker of poor interoception and emotion regulation rather than a fixed personality trait.

These findings isolate specific change mechanisms in mindfulness-induced wellbeing, highlighting interoceptive awareness dimensions, acceptance and attention as critical mediators and biomarkers warranting further investigation in mindfulness-based, real world intervention research.

Publication Type:	Thesis (Doctoral)
Subjects:	B Philosophy. Psychology. Religion > BF Psychology R Medicine > RC Internal medicine > RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry R Medicine > RM Therapeutics. Pharmacology
Departments:	School of Health & Medical Sciences > Department of Psychology & Neuroscience School of Health & Medical Sciences > School of Health & Medical Sciences Doctoral Theses Doctoral Theses

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