Psychology and Aging
2015, Vol. 30, No. 1, 160 –171
© 2014 American Psychological Association
0882-7974/15/$12.00 http://dx.doi.org/10.1037/a0038544
The Role of Emotion Regulation and Cognitive Control in the Association
Between Mindfulness Disposition and Stress
Ruchika Shaurya Prakash
Mariam A. Hussain
The Ohio State University
Defense and Veterans Brain Injury Center, Camp Pendleton,
California
Brittney Schirda
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The Ohio State University
Dispositional mindfulness is associated with lower levels of perceived stress, with increased emotional
regulation and cognitive control proposed as mechanisms underlying these stress-buffering effects of
mindfulness. Within aging, these controlled processes represent paradoxically divergent trajectories such
that older adults exhibit reduced cognitive control capacities, while emotional regulation abilities are well
maintained, and at times enhanced. Our study seeks to examine the role of emotional regulation and
cognitive control as possible mediators of the association between mindfulness and perceived stress. In
addition, we examined age-related differences in the observed associations among mindfulness, stress,
and controlled regulatory behavior. Fifty older adults and fifty young adults were recruited for the study
and completed self-report measures assessing mindfulness disposition, perceived stress, and emotional
regulation. In addition, computerized measures of cognitive control assessing working memory, inhibitory control, and set-shifting were also administered. We hypothesized a negative correlation between
mindfulness disposition and perceived stress such that participants reporting higher levels of dispositional
mindfulness would report lower stress. In addition, we hypothesized increased difficulties in emotion
regulation and lower cognitive control to mediate this relationship. Corroborating previous literature,
results revealed that mindfulness disposition and perceived stress were negatively correlated in both
groups. However, emotion regulation, but not cognitive control, was found to mediate the relationship
between mindfulness and perceived stress in both groups. Age group was not found to moderate the
observed effects. Our findings reveal the role of enhanced emotional regulation abilities as a potential
factor associated with the stress-reducing capacity of dispositional mindfulness.
Keywords: dispositional mindfulness, perceived stress, aging, emotion regulation, cognitive control
physiological (Brown, Weinstein, & Creswell, 2012) metrics of
stress. Recently, de Frias and Whyne (2014) provided evidence for
the buffering effect of mindfulness on the functional ramifications
of stress in older adults, such that higher levels of trait mindfulness
in older adults moderated the effect of life stressors on mental
health. Building on this nascent literature, in this study, we examined the association between dispositional mindfulness and perceived levels of stress in our sample of older and young adults. We
hypothesized, based on existing literature, an inverse association
between dispositional mindfulness and perceived levels of stress
for older and young adults.
In addition, extending the current literature, we examined if
emotion regulation abilities along with cognitive control capacities
would be associated with dispositional mindfulness and stress in
this sample of older and young adults. Both of these regulatory
processes have been recently acknowledged as critical mechanisms in the proposed theoretical models of mindfulness (Hölzel et
al., 2011). In fact, embedded within the definition and theoretical
conceptualizations of mindfulness is an intentional invocation of
sustained nondistraction, thereby allowing one to be fully aware of
the experiences of the present moment (Brown & Ryan, 2003;
Kabat-Zinn, 1982). Supporting this association between mindfulness and facets of cognitive control, there is empirical support for
The contemporary study of mindfulness has seen a surge of
interest in the last decade, governed, in part, by the collective
realization of the physiological and psychological ramifications of
high stress that is increasingly pervading our society. Although this
construct of mindfulness has historical roots in the Buddhist traditions (Bodhi, 2011), seminal work by Jon Kabat-Zinn afforded
the Western adaptation of these teachings in an 8-week groupbased program, popularized as the mindfulness-based stress reduction program (MBSR; Kabat-Zinn, 1990). As such, since its inception, mindfulness has been extensively studied in crosssectional and longitudinal studies with respect to its associations
with self-report (Bränström, Duncan, & Moskowitz, 2011) and
This article was published Online First December 29, 2014.
Ruchika Shaurya Prakash, Department of Psychology, The Ohio State
University; Mariam A. Hussain, Defense and Veterans Brain Injury Center,
Camp Pendleton, California; Brittney Schirda, Department of Psychology,
The Ohio State University.
Correspondence concerning this article should be addressed to Ruchika
Shaurya Prakash, Department of Psychology, The Ohio State University,
139 Psychology Building, 1835 Neil Avenue, Columbus, OH 43210.
E-mail: [email protected]
160
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MINDFULNESS AND STRESS
expert meditators to perform better than novices on tasks of
attentional orienting (van den Hurk, Giommi, Gielen, Speckens, &
Barendregt, 2010), conflict monitoring (Chan & Woollacott, 2007;
Jha, Krompinger, & Baime, 2007; van den Hurk et al., 2010), and
cognitive flexibility (Moore & Malinowski, 2009). There is also
support for improvement in cognitive control abilities of working
memory and attentional orienting in individuals participating in 6to 8-week training programs designed to teach skills of concentrative attention and open monitoring (Jha et al., 2007; Jha, Stanley, Kiyonaga, Wong, & Gelfand, 2010; although see Moynihan et
al., 2013 and Anderson, Lau, Segal, & Bishop, 2007 for findings
of nonsignificant results).
Although limited, cross-sectional studies suggest that higher
levels of dispositional mindfulness are also associated with performance on measures of cognitive control, such as inhibitory
control and working memory in adolescents (Oberle, SchonertReichl, Lawlor, & Thomson, 2011) and young adults (Anicha,
Ode, Moeller, & Robinson, 2012). However, within older adults,
we are not aware of any cross-sectional studies examining associations of dispositional mindfulness with metrics of cognitive
control. Thus, in this study, extending the current literature, we
examined if dispositional mindfulness would be associated with
various facets of cognitive control in older and young adults.
Furthermore, another critical component of the theoretical
framework of mindfulness is the ability to better regulate responses to arising emotional experiences. That is, with increased
attention regulation and awareness of the experiences of the present moment, the reactivity of the wandering mind can in fact be
reduced, resulting in greater emotion regulation (Bishop et al.,
2004). Supporting this conjecture, there is evidence of reduced
emotional reactivity in expert meditators relative to novices (Taylor et al., 2011), improvements in skills and neural correlates of
emotion regulation after MBSR (Allen et al., 2012; Garland,
Gaylord, & Fredrickson, 2011), and positive associations between
measures of dispositional mindfulness and self-report measures of
emotion regulation (Desrosiers, Vine, Klemanski, & NolenHoeksema, 2013). Although there are no studies that have examined mindfulness and emotion regulation in the elderly, Raes,
Bruyneel, Loeys, Moerkerke, and De Raedt (2013) found dispositional mindfulness to mediate the age-related decreases in negative affect, such that the observed decrease in experience of
negative emotions that accompany aging can in fact partly be
accounted for by the age-related increase in trait mindfulness
levels. Thus, although there is clear evidence for emotion regulation to be associated with mindfulness, there is no study, to our
knowledge, that has examined the association between dispositional mindfulness and emotion regulation in a population of older
adults.
Taken together, the above reviewed literature presents evidence
for the involvement of emotion regulation and cognitive control as
possible mechanisms through which mindfulness might be associated with psychological prophylaxis. On the basis of the empirical literature and theoretical formulations of mindfulness, we
further examined if emotion regulation and cognitive control capacities would mediate the association between mindfulness and
stress in older and young adults. Acknowledging the limitations of
conducting such mediational analyses in a cross-sectional dataset
given the inherent assumptions of causality (Lindenberger & Pötter, 1998), these analyses were conducted as a preliminary attempt
161
to examine the pathway through which mindfulness might be
associated with stress in a sample of older and young adults.
Furthermore, we believe that the aging brain presents a particularly interesting landscape to study these two processes because
of their divergent trajectories as a function of age (Charles, 2010;
Hay & Diehl, 2011; Park et al., 2002; Salthouse, 2010). Older
adults exhibit age-related deficits in cognitive control of working
memory, inhibitory control, and mental flexibility, which have
been found to be related to error-prone goal maintenance (Braver
& Barch, 2002; Braver, Satpute, Rush, Racine, & Barch, 2005;
Paxton, Barch, Racine, & Braver, 2008). On the other hand,
although cognitive performance and cognitive control resources
may not be efficiently utilized in the elderly, older adults demonstrate well-maintained, and at times, enhanced capacities for emotional regulation (for a review, see Mather, 2012). In turn, these
have been hypothesized to support their shifting socioemotional
goals related to enhanced emotional regulation and are likely
responsible for the greater levels of emotional well-being often
reported by adults in their older ages (Carstensen, 1992; Charles &
Piazza, 2007; Newsom, Rook, Nishishiba, Sorkin, & Mahan,
2005). Thus, given older adults’ predilection toward regulating
emotional experiences, we hypothesized age-related differences in
associations among dispositional mindfulness, emotion regulation,
and perceived stress such that emotion regulation would play a
critical role in the relation between mindfulness and stress for
older compared with young adults.
To summarize, the current study had two main aims: (a) to
examine if mindfulness disposition would be associated with perceived stress, emotion regulation, and cognitive control in older
and young adults such that the relationship between mindfulness
disposition and perceived stress would be mediated by emotion
regulation and cognitive control capacities in the context of a
multiple mediation model and (b) whether age group would moderate the observed mediation by emotion regulation and cognitive
control. We hypothesized both emotion regulation and cognitive
control capacity to mediate the association between dispositional
mindfulness and perceived stress in both cohorts, with emotion
regulation being the stronger of the two mediators. In addition, we
hypothesized older adults to show stronger associations among
mindfulness, emotion regulation, and perceived stress. However,
given the dearth of studies examining associations between dispositional mindfulness and cognitive control, we did not have an a
priori hypothesis regarding the moderation of cognitive control by
age group.
Method
Participants
Fifty older and fifty young adult participants were recruited to
participate in the study from the Columbus, OH, community
through the use of newspaper ads, flyers, and presentations given
at local senior centers. The sample was drawn from a larger study
that had two primary aims: (a) to investigate age-related differences in contextual emotion regulation and (b) to examine behavioral and neural associations between individual differences in
dispositional mindfulness, emotional regulation, and cognitive
control in older and young adults. Here, we present the behavioral
data examining age-related differences in associations among dis-
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162
PRAKASH, HUSSAIN, AND SCHIRDA
positional mindfulness, perceived stress, and emotional and cognitive control.
Participant inclusionary criteria included being between the ages
of 60 and 80 years for older adults and 18 and 30 years for young
adults; a score ⬎23 on the Mini-Mental Status Examination
(MMSE; maximum score ⫽ 30; Folstein, Folstein, & McHugh,
1975); a score of ⬍10 on the Geriatric Depression Scale for older
adults and a score of ⬍18 on the Beck Depression Inventory for
young adults; corrected near and far acuity vision of 20/40 or
better; right-handedness as assessed by the Edinburgh Handedness
Inventory; no history of self-reported psychiatric or neurologic
disorders, untreated hypertension, or chronic inflammatory diseases; and no regular use of steroid medication or hormone replacement therapy. In addition, a subset of these participants (20
older and 20 young adults) were also required to meet magnetic
resonance imaging (MRI) safety criteria that included no metallic
implants and an absence of claustrophobia to participate in the
MRI portion of the study. All participants provided written informed consent before participating as required by The Ohio State
University Review Board.
Procedure
To determine eligibility, potential participants underwent a short
phone-screening interview lasting approximately 10 –15 min. Data
for this current study were collected at study Session 1 and study
Session 2, which typically took place approximately 1 week apart.
Participants completed computerized cognitive tasks during Session 1. In the period between Sessions 1 and 2, participants
completed self-report questionnaires and these questionnaires were
collected at Session 2. All participants were compensated $8/hr for
their time.
Questionnaires
Mindful Attention Awareness Scale. The Mindful Attention
Awareness Scale (MAAS; Brown & Ryan, 2003) is a 15-item
self-report questionnaire scored on a 6-point rating scale from 1
(almost always) to 6 (almost never), which assesses the experience
of mindfulness in a general, everyday context. Mindfulness is
measured on the basis of attention and awareness of thought,
emotions, and actions. Higher scores on the MAAS reflect higher
levels of mindfulness disposition. The MAAS has been shown to
have good reliability and validity (Brown & Ryan, 2003) as well
as having been used in various populations such as in adolescents,
cancer patients, and healthy adults (Brown, West, Loverich, &
Biegel, 2011; Carlson & Brown, 2005; MacKillop & Anderson,
2007). An example statement is, “I rush through activities without
really being attentive to them.” Cronbach’s ␣ for older adults ⫽
0.766 and for young adults ⫽ 0.900.
Perceived Stress Scale. The Perceived Stress Scale (PSS;
Cohen, Kamarck, & Mermelstein, 1983) is a 10-item self-report
questionnaire scored on a 5-point rating scale from 0 (never) to 4
(very often), which measures the perception and appraisal of stress
in one’s life. Higher scores on the PSS reflect higher levels of
stress and more feelings of unpredictability, uncontrollability, and
overloadedness. An example item from the scale is, “In the last
month, how often have you felt difficulties were piling up so high
that you could not overcome them?” Cronbach’s ␣ for older
adults ⫽ 0.855 and for young adults ⫽ 0.869.
Difficulties in Emotion Regulation Scale. The Difficulties
in Emotion Regulation Scale (DERS; Gratz & Roemer, 2004) is
a 36-item self-report questionnaire measured on a 5-point rating
scale from 1 (almost never) to 6 (almost always), which evaluates emotion regulation difficulties with nuanced subscales:
nonacceptance of emotional responses (nonacceptance), difficulties in engaging in goal-directed behavior (goals), impulse
control difficulties (impulse), lack of emotional awareness
(aware), limited access to emotion regulation strategies (strategies), and lack of emotional clarity (clarity). Scores from the
six subscales were summed to create an overall measure of
emotion regulation difficulty. Higher scores on this scale indicate greater perceived difficulties in emotion regulation capabilities. An example item from the questionnaire includes,
“When I’m upset, I feel like I can remain in control of my
behaviors.” (reverse-scored; impulse control). Cronbach’s ␣ for
older adults ⫽ 0.905 and for young adults ⫽ 0.886.
White Bear Suppression Inventory. The White Bear Suppression Inventory (WBSI; Wegner & Zanakos, 1994) is a 15-item
self-report questionnaire measured on a 5-point rating scale from
A (1; strongly disagree) to E (5; strongly agree), which evaluates
thought suppression. Higher scores on this scale indicate greater
tendencies to engage in suppressing thought processes. An example item from the questionnaire includes, “I always try to put
problems out of mind.” Cronbach’s ␣ for older adults ⫽ 0.899 and
for young adults ⫽ 0.894.
Cognitive measures. We assessed the construct of cognitive
control by selecting a measure for each of three categories of
cognitive control proposed by Miyake et al. (2000): working
memory, inhibitory control, and set-shifting.
N-back task. Participants were presented with a series of
letters, which appeared one at a time, and were asked to
determine whether the letter presented on the screen matched
the one immediately prior (1-back condition) or matched the
letter that was presented two letters prior (2-back condition).
Participants responded using their right-index finger for a
match and responded with their left-index finger for no match.
Participants first completed a block of practice trials for the
1-back condition and a block of practice trials for the 2-back
condition, following which the two conditions were presented
twice in a randomized order. Thus, all participants completed
four blocks of 30 trials each. Each block started with an
instruction screen that lasted for 3,000 ms. Each letter was on
the screen for 1,500 ms, with an allowable response window of
2,000 ms and an interstimulus interval of 1,500 ms. Fixation
blocks were interleaved before the instruction screens and after
the task blocks, each lasting for 4,500 ms. The dependent measures of interests were the n-back costs (NbackRTCost and NbackAccCost), reflecting decreased behavioral performance with increased working memory load.
Flanker task. Participants were presented with a series of five
arrows on a computer monitor and were asked to respond to the
orientation of the central arrow and ignore the peripheral arrows.
Participants completed a block of practice trials before starting the
experimental block, which included a total of 100 trials. For half of
the trials, all five arrows pointed in the same direction (congruent
condition), and for the other half of the trials, the central arrow
pointed in the opposite direction to that of the flanking arrows
(incongruent condition). On 50% of the trials the arrows pointed
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MINDFULNESS AND STRESS
left and on the remaining 50% the arrows pointed right. Each
stimulus was presented for 1,500 ms and an interstimulus interval
of 800 ms. The dependent measures of interests were the flanker
costs (FlankerRTCost and FlankerAccCost) reflecting the decrease
in behavioral performance resulting from processing incompatible
information relative to compatible information.
Task-switching paradigm. Participants performed single
task blocks and dual task blocks to assess the costs associated with
maintaining single versus dual attentional sets (global costs) and
the costs associated with set-shifting within a dual block (local
costs). Stimuli consisted of single digits (except for 5) presented on
the screen one at a time, with the participant responding to a
judgment of ⬎5 or ⬍5 if the background was blue and responding
to odd/even judgments if the background was pink. All participants
first completed two separate practice blocks of the single task
blocks. This was followed by a presentation of the experimental
single task blocks of 24 trials each. Participants then completed a
practice dual task block in which they were asked to respond to the
digit on the screen based on the background. They then completed
a dual task block of 120 trials, with 60 nonswitch trials and 60
switch trials. Each trial was presented on the screen for 2,500 ms.
The dependent variable of interest included the switch costs
associated with maintaining two attention sets (global costs),
which were defined as performance decrements in reaction time
(RT) and accuracy scores in the nonswitch trials of the dual task
block relative to the single task trials. In addition, we also calculated the switch cost associated with shifting between tasks during
the presentation of the dual task block (local costs), which were
defined as decreased behavioral performance in RT and accuracy
scores in the switch trials of the dual task block relative to the
nonswitch trials of the dual task block.
163
Statistical Analyses
Analyses were performed using SPSS 21.0 (IBM, Armonk,
NY). Two of the 50 older adults did not complete the PSS; thus, all
analyses were conducted on the remaining 48 older adults and 50
young adults. Table 1 presents the demographics for older and
young adults.
All questionnaire data and cognitive task data were first tested
for outliers. Outlier correction was separately done within the two
groups. Outliers were defined as any z-score ⫾ 2.5 SD from the
mean; scores exceeding this threshold were replaced with z-scores
equivalent to 2.5 SD. Normality of the questionnaire data and
cognitive data was checked using the Shapiro-Wilk test for normality. We first conducted bivariate correlations to examine associations between our variables of interest. Table 2 presents the
bivariate correlations (Pearson correlations for normally distributed data and Spearman’s rho [␳] for non-normally distributed
data) between the emotion regulation measures as well as the
cognitive control measures. For each of the broad constructs of
emotion regulation and cognitive control, we administered multiple measures that would allow us to create a composite score for
the respective constructs. As can be seen from Table 2, both
measures of emotion regulation (DERS and WBSI) were significantly correlated for both older (␳ ⫽ 0.51, p ⬍ .01) and young
adults (r ⫽ .68, p ⬍ .01). Thus, we created a composite for the
emotional regulation construct by taking an average of the two
scores. This composite was then multiplied by ⫺1 so that higher
scores reflected better perceived emotion regulation abilities. The
DERS and the WBSI scores as included in Tables 1 and 2 are the
original DERS and WBSI scores, with higher scores reflecting
greater difficulties in emotion regulation and increased thought
Table 1
Study Sample Demographics and Characteristics for Older Adults (N ⫽ 48) and Young Adults (N ⫽ 50)
Demographic/
characteristic
Age
Education
Gender
Male
Female
MAAS
PSS
WBSI
DERS
Task-Switching
GlobalRTCost
GlobalAccCost
LocalRTCost
LocalAccCost
Nback
NbackRTCost
NbackAccCost
Flanker
FlankerRTCosta
FlankerAccCosta
a
Older adults
Mean
SD
Median
65.40
17.10
4.83
2.35
17
31
4.56
9.12
36.25
63.44
—
—
0.51
5.37
11.06
12.79
—
—
4.6
8
35.50
62.50
212.78
⫺0.03
251.57
0.02
107.50
0.10
126.63
0.05
202.31
.000
245.96
.004
164.54
0.24
118.52
0.14
95.38
0.04
47.99
0.05
Young adults
Mean
SD
60–79
12–22
23.60
16.34
3.27
2.27
—
—
3.20–5.73
1–23
16–65
44–98
18
32
4.09
15.05
43.86
70.56
—
—
0.91
6.78
12.38
16.68
—
—
4.2
14
44
70
—
—
2.20–5.80
1–28
19–68
37–113
34.10–520.04
⫺0.42–0.10
⫺194.33–502.31
⫺0.04–0.22
188.26
0.01
270.41
0.03
88.83
0.03
98.94
0.05
176.46
0.006
260.90
0.016
⫺31.97–365.79
⫺0.09–0.10
121.42–663.98
⫺0.03–0.17
t ⫽ 1.23
U ⫽ 882.50ⴱ
U ⫽ 1,161.00
U ⫽ 1,000.50
181.44
0.208
⫺120.15–380.47
⫺0.04–0.60
228.50
0.13
104.31
0.09
253.20
.13
⫺56.54–423.56
⫺0.05–0.42
U ⫽ 831.00ⴱⴱ
t ⫽ 4.28ⴱⴱ
89.06
.02
8.28–287.12
⫺0.04–0.2
60.66
0.03
25.96
0.03
62.51
.02
0.13–130.12
0.03–0.12
U ⫽ 576.00ⴱⴱ
U ⫽ 1,003.00
64
18
Range
Median
24
16
Range
Age comparisons
18–30
12–21
U ⫽ .000ⴱⴱ
U ⫽ 986.00
␹2 ⫽ .004
t ⫽ 3.14ⴱⴱ
U ⫽ 567.50ⴱⴱ
t ⫽ –3.20ⴱⴱ
U ⫽ 843.00ⴱ
For the flanker task, data were lost for one older adult and one young adult. The results for the flanker task are presented with 47 older adults and 49
young adults.
ⴱ
p ⬍ .05. ⴱⴱ p ⬍ .01.
PRAKASH, HUSSAIN, AND SCHIRDA
164
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Table 2
Bivariate Correlations Among Mindfulness Disposition, Perceived Stress, Emotion Regulation Abilities, and Cognitive Control
Capacities in Older Adults and Young Adults
MAAS
OA
YA
PSS
OA
YA
ER_Composite
OA
YA
DERS
OA
YA
WBSI
OA
YA
GlobalRTCost
OA
YA
GlobalAccCost
OA
YA
LocalRTCost
OA
YA
LocalAccCost
OA
YA
NBackRTCost
OA
YA
NBackAccCost
OA
YA
FlankerRTCost
OA
YA
FlankerAccCost
OA
YA
MAAS
PSS
1
⫺0.31ⴱ
⫺0.60ⴱⴱ
1
ER_Composite
0.33ⴱⴱ
0.73ⴱⴱ
⫺0.56ⴱⴱ
⫺0.64ⴱⴱ
1
DERS
WBSI
⫺0.41ⴱⴱ ⫺0.34ⴱ
⫺0.59ⴱⴱ ⫺0.78ⴱⴱ
Global Global
Local
Local
Nback Nback Flanker Flanker
RTCost AccCost RTCost AccCost RTCost AccCost RTCost AccCost
0.00
0.17
⫺0.11
0.24
0.00
⫺0.15
⫺0.15
⫺0.21
0.19
⫺0.01
0.47ⴱⴱ
0.66ⴱⴱ
⫺0.03
0.02
0.13
⫺0.25
⫺0.05
0.02
0.08
0.21
⫺0.20
⫺0.03
⫺0.83ⴱⴱ ⫺0.88ⴱⴱ
⫺0.94ⴱⴱ ⫺0.89ⴱⴱ
0.18
0.11
⫺0.19
0.18
0.01
⫺0.09
⫺0.18
⫺0.20
0.19
⫺0.01
0.18
0.08
0.20
⫺0.12
0.09
⫺0.03
0.51ⴱⴱ
0.68ⴱⴱ
⫺0.20
⫺0.10
0.27
⫺0.12
0.12
⫺0.01
0.05
0.18
⫺0.20
0.06
⫺0.14
⫺0.08
⫺0.08
0.05
0.12
0.08
1
⫺0.09
⫺0.11
0.04
⫺0.22
⫺0.11
0.22
0.20
0.20
⫺0.10
⫺0.07
⫺0.21
⫺0.06
⫺0.25
0.17
⫺0.26
⫺0.05
⫺0.03
⫺0.26
0.31ⴱ ⫺0.40ⴱⴱ ⫺0.31ⴱ
⫺0.12 ⫺0.02
⫺0.21
0.48ⴱⴱ
0.54ⴱⴱ
1
1
0.13
0.11
1
⫺0.47ⴱⴱ ⫺0.32ⴱ
⫺0.08
0.05
⫺0.06
⫺0.11
⫺0.14
0.07
⫺0.11 ⫺0.28
⫺0.29ⴱ
0.04
0.17
⫺0.11
0.02
0.07
0.01
0.19
⫺0.28
0.08
⫺0.20
0.22
0.14
0.04
0.01
⫺0.09
0.00
0.19
1
0.04
⫺0.05
0.03
0.01
⫺0.15
0.25
0.10
0.17
0.02
0.10
1
0.03
0.04
0.04
0.06
⫺0.08
⫺0.09
⫺0.08
⫺0.09
1
0.23
0.27
⫺0.07
⫺0.07
0.09
⫺0.12
1
0.10
⫺0.01
⫺0.12
⫺0.09
1
⫺0.08
0.26
1
Note. Higher numbers reflect higher MAAS, higher PSS, higher perceived emotion regulation abilities (ER_Composite), higher difficulties in emotion
regulation (DERS), increased thought suppression tendencies (WBSI), greater reaction time cost, and greater accuracy cost. OA ⫽ older adult; YA ⫽ young
adult.
ⴱ
p ⬍ .05. ⴱⴱ p ⬍ .01.
suppression, respectively. In addition, and in contrast to the emotion regulation measures, as can be seen from Table 2, there were
weak to no correlations among the cognitive control variables, thus
precluding us from creating a cognitive control composite. These
variables were entered separately in the multiple mediation models
described below.
We then used Preacher and Hayes’ bias-corrected nonparametric bootstrapping techniques with 5,000 bootstrap samples to estimate the direct and indirect effects of dispositional mindfulness
on levels of perceived stress. This was done using the PROCESS
macro for SPSS. Bootstrapping mediation tests are preferred over
other mediation methods because they do not assume a normal
sampling distribution of the indirect effects (Preacher & Hayes,
2008). The point estimates of the indirect effects were considered
statistically significant if the 95% confidence intervals (CIs) did
not contain zero.
We first constructed simple mediation models to examine
whether emotional regulation and the various metrics of cognitive
control separately mediate the association between dispositional
mindfulness and stress in both older and young adults. Data on the
flanker task were lost from one older adult and one young adult;
thus, analyses based on the flanker task included a sample size of
47 for older adults and 49 for young adults. We then constructed
and tested two multiple mediation models that took into account all
of the mediator variables in one model, thus allowing each mediator to be examined in the context of other mediators. These two
multiple mediation models were constructed separately for older
and young adults to examine the relative contribution of each of
the mediators for the two cohorts.
Finally, again using the PROCESS macro, we examined if age
group moderated the conditional indirect effect of dispositional
mindfulness on perceived stress. This model allowed us to exam-
MINDFULNESS AND STRESS
table, for both age groups, dispositional mindfulness was negatively associated with levels of perceived stress (␳ ⫽ ⫺0.31 for
older adults and r ⫽ ⫺0.60 for young adults). The composite of
emotion regulation was found to be positively associated with
mindfulness disposition (␳ ⫽ 0.33 for older adults and r ⫽ .73 for
young adults) and negatively associated with perceived stress
(␳ ⫽ ⫺0.56 for older adults and r ⫽ ⫺0.64 for young adults).
However, the various indices of cognitive control were not found
to be associated with either mindfulness or perceived stress (except
for n-back accuracy cost in young adults).
Although cognitive control indices were not associated with
either mindfulness or perceived stress, we were interested in examining if perceived emotion regulation abilities would mediate
the association between mindfulness and stress in the context of
other proposed mediators. For this, we first conducted simple
mediation analyses using a bootstrapping approach that does not
make assumptions about normality of indirect effects. This was
done separately for each of the mediators. The results of the simple
mediation analyses for older and young adults are presented in
Table 3. As can be seen from the table, of the possible mediators
examined, the composite score of emotion regulation abilities was
found to be the only significant mediator of the association between dispositional mindfulness and perceived stress for older
(point estimate of ⫺0.193; CI: ⫺0.410 to ⫺0.062) and young
adults (point estimate of ⫺0.157; CI: ⫺0.288 to ⫺0.057). The
direct effect of mindfulness on perceived stress was found to be
nonsignificant for older adults (point estimate of ⫺0.044; p ⫽ .67)
and young adults (point estimate of ⫺0.142; p ⫽ .08), suggesting
perceived emotion regulation abilities to fully mediate the association.
We then constructed our multiple mediation model to examine
if the mediation by emotion regulation remained significant even
ine the moderating effect of age group on the direct and indirect
effects of mindfulness on perceived levels of stress. In addition, we
calculated Hayes’ index of moderated mediation included in the
PROCESS macro for SPSS (Hayes, 2014) to test for the presence
of moderated mediation. This index tests for a nonzero weight of
the moderator in the indirect effect process. In here, a bootstrapping technique with 5,000 resamples was used providing a 95%
CI; if the CI did not include zero, then moderated mediation was
indicated.
Results
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165
Descriptive statistics, including means, medians, standard deviations, and range for all variables of interest, are presented in Table
1. To examine age-related differences, we conducted independentsample t tests for variables with a normal distribution, and where
assumptions of normality were not met, we conducted the Mann–
Whitney U test. The two groups did not statistically differ on
education (U (98) ⫽ 986, p ⫽ .12) or gender ratios (␹2 ⫽ 0.004,
p ⬎ .05). In addition, older adults, on average, reported higher
levels of dispositional mindfulness, t(77.73) ⫽ 3.14, p ⫽ .002, and
lower levels of perceived stress (U (98) ⫽ 567.50, p ⬍ .001).
Corroborating previous literature, older adults showed lower
thought suppression, t(96) ⫽ ⫺3.20, p ⫽ .002, and fewer difficulties with emotion regulation (U (98) ⫽ 843, p ⫽ .01) compared
with young adults. In addition, older adults demonstrated higher
accuracy costs on the n-back task, t(80.79) ⫽ 4.28, p ⬍ .001, and
greater RT cost on the flanker task (U (96) ⫽ 576, p ⬍ .001).
Contrary to our expectations, older adults showed less RT cost on
the n-back task (U (98) ⫽ 831, p ⫽ .009) and lower global
accuracy costs (U (98) ⫽ 882.50, p ⫽ .02).
In addition, Table 2 presents the bivariate correlations among all
variables for both older and young adults. As can be seen from the
Table 3
Results for the Simple Mediation Models for Older and Young Adults
Mediator
IV on M (a)
M on DV (b)
Emotion Regulation
GlobalRTCost
GlobalAccCost
LocalRTCost
LocalAccCost
NbackRTCost
NbackAccCost
FlankerRTCosta
FlankerAccCosta
0.740
0.015
0.002
0.071
⫺0.001
2.916
0.000
⫺0.371
⫺0.001
⫺0.261
⫺0.002
⫺1.768
⫺0.003
9.889
⫺0.002
⫺3.636
⫺0.028
11.433
Emotion Regulation
GlobalRTCost
GlobalAccCost
LocalRTCost
LocalAccCost
NbackRTCost
NbackAccCost
FlankerRTCosta
FlankerAccCosta
0.715
1.101
0.001
⫺0.251
⫺0.001
⫺0.340
0.001
⫺0.241
0.000
⫺0.220
0.010
⫺24.502
⫺0.005
10.015
⫺0.004
⫺17.983
0.008
⫺8.854
Indirect Effect (a ⫻ b)
Older adults
Young adults
Direct Effect (c’)
Total Effect (c)
⫺0.193ⴱ
0.000
⫺0.003
⫺0.0002
⫺0.009
⫺0.006
⫺0.001
0.010
⫺0.014
⫺0.044
⫺0.237
⫺0.234
⫺0.236
⫺0.228
⫺0.231
⫺0.236
⫺0.253
⫺0.229
⫺0.237
⫺0.237
⫺0.237
⫺0.237
⫺0.237
⫺0.237
⫺0.237
⫺0.243
⫺0.243
⫺0.157ⴱ
0.011
⫺0.013
0.001
⫺0.009
0.001
⫺0.009
⫺0.002
⫺0.003
⫺0.142
⫺0.310
⫺0.286
⫺0.300
⫺0.291
⫺0.300
⫺0.291
⫺0.297
⫺0.296
⫺0.299
⫺0.299
⫺0.299
⫺0.299
⫺0.299
⫺0.299
⫺0.299
⫺0.299
⫺0.299
Note. Significant point estimates (p ⬍ .05) as determined by the bootstrapping technique of Preacher & Hayes (2008).
Please note that for older and young adults, the simple mediation analyses for the flanker task included one less participant than the other models. IV ⫽
independent variable; M ⫽ mediator; DV ⫽ dependent variable.
a
PRAKASH, HUSSAIN, AND SCHIRDA
166
after including the other mediators. This multiple mediation
model, although constructed with a modest sample size and a large
number of proposed mediators, was primarily constructed to ensure that emotion regulation abilities would mediate the association between mindfulness and stress even after including other
proposed mediators. Figure 1 separately displays the results of the
multiple mediation models for older and young adults. Corroborating the results of the simple mediation analyses, we still found
only the composite of emotion regulation to be a significant
mediator for older adults (point estimate of ⫺0.175; CI: ⫺0.424
to ⫺0.023) and young adults (point estimate of ⫺0.157; CI:
⫺0.291 to ⫺0.033). Taken together, the results of the simple
A
Emotion Regulation Abilities
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0.736 (0.18)**
-0.238 (0.08)**
c: -0.243 (0.099) *
Mindfulness
Disposition
Perceived
Stress
c’: -0.049 (0.118)
-0.107 (2.10)
Global RT Cost
-0.006 (0.01)
0.001 (0.002)
Global Accuracy Cost
-2.073 (8.24)
0.096 (2.48)
Local RT Cost
-0.004 (0.007)
Local Accuracy Cost
-5.521 (17.01)
NBack RT Cost
-0.002 (0.007)
-0.0008 (0.001)
3.355 (2.23)
-0.002 (0.003)
Nback Accuracy Cost
-0.371 (0.93)
Flanker RT Cost
-0.024 (0.02)
-0.001 (0.001)
Flanker Accuracy Cost
18.125 (15.04)
B
2.292 (6.21)
Emotion Regulation Abilities
-0.219 (0.08)*
0.715 (0.10)**
c: -0.299 (0.057)**
Mindfulness
Disposition
Perceived
Stress
c’: -0.112 (0.085)
1.103 (0.94)
0.0005 (0.0003)
-0.246 (1.06)
-0.0008 (0.0005)
-0.344 (1.11)
0.0005 (0.001)
-0.241 (0.27)
0.0003 (0.0004)
Global RT Cost
Global Accuracy Cost
0.008 (0.10)
-30.368 (29.26)
Local RT Cost
0.001 (0.01)
Local Accuracy Cost
8.693 (17.60)
NBack RT Cost
0.004 (0.01)
Nback Accuracy Cost
Flanker RT Cost
Flanker Accuracy Cost
-18.500 (8.81)
0.004 (0.03)
-12.067 (24.94)
Figure 1. Results for the multiple mediation model tested in (A) older and (B) young adults. For each of the
mediators, the unstandardized path coefficients with SE in parentheses are indicated. Significant indirect
pathways are boldfaced. The solid line connecting disposition mindfulness with perceived stress indicates the
total effect of mindfulness on stress, and the dotted line coefficient indicates the direct effect of stress. Given that
this was the multiple mediation model, simultaneously testing all mediators, the total effect for both older adults
is based on N ⫽ 47 and for young adults is based on N ⫽ 49 participants.
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MINDFULNESS AND STRESS
mediation analyses and multiple mediation analyses evince support for emotion regulation abilities to mediate the association
between dispositional mindfulness and perceived stress.
Next, to examine the moderating effects of age group in the
observed mediation, we constructed a moderated mediation model
to examine if age group moderated the association among (a)
dispositional mindfulness and each of the mediator variables, (b)
each of the mediator variables and levels of perceived stress, and
(c) dispositional mindfulness and perceived stress. The results of
this moderated mediation are presented in Figure 2. As can be seen
from the figure, none of the interactions were significant, thus
suggesting that there were no age-related differences in the associations among dispositional mindfulness, perceived stress, and the
examined mediators. Emotion regulation was found to be a significant mediator in this multiple mediation model for older (point
estimate of ⫺0.175; CI: ⫺0.448 to ⫺0.026) and young adults
(point estimate of ⫺0.157; CI: ⫺0.292 to ⫺0.034), with the index
of moderated mediation being nonsignificant (index ⫽ 0.019;
CI: ⫺0.185 to 0.303).
Discussion
The purpose of the present study was to examine the association
between dispositional mindfulness and perceived stress and to
identify potential mediators of this relationship in a community
sample of older and young adults. We were specifically interested
in examining if the relationships that have been observed among
167
dispositional mindfulness, cognitive control, and emotion regulation in young adults would also be found in a sample of older
adults and if age group would moderate any of the observed
relationships. Corroborating previous literature, the results of our
study provided evidence for an inverse relationship between dispositional mindfulness and levels of perceived stress in older and
young adults. However, age group was not a significant moderator
of this relationship. Furthermore, our findings revealed that perceived emotion regulation abilities fully mediated the negative
association between mindfulness disposition and perceived stress;
however, as defined in this study, cognitive control was not associated with either mindfulness disposition or perceived stress in
either older or young adults. The results from this study highlight
the role of enhanced emotional regulation abilities as a potential
underlying mechanism contributing to the stress-reducing capacity
of dispositional mindfulness; however, these results did not differ
as a function of age.
Consistent with prior literature, our findings provide additional
evidence for the positive psychological health benefits associated
with mindfulness, particularly in the area of stress reduction. A
review of randomized controlled trials (RCTs) investigating the
effectiveness of mindfulness programs on various symptoms found
that mindfulness training resulted in significant reductions in perceived stress in seven of eight RCTs, with pre-post effect sizes
ranging from 0.3 to 0.64 (Fjorback, Arendt, Ornbøl, Fink, &
Walach, 2011). In addition, cross-sectional studies investigating
Figure 2. Results for the moderated mediation model testing for age-related differences in associations among
dispositional mindfulness, cognitive control, and emotion regulation. For each of the examined interactions, the
unstandardized path coefficients with SE in parentheses are indicated. This model included both groups of
participants with all data (N ⫽ 96).
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168
PRAKASH, HUSSAIN, AND SCHIRDA
dispositional mindfulness have found this trait measure to be
associated with subjective reports of stress as well as neuroendocrine markers of stress (Bränström et al., 2011; Brown et al.,
2012). Overall, there seems to be consistent support for the stressbuffering effect of mindfulness when examined as an individual
difference metric and in the context of mindfulness-based stress
reduction programs. Extending this literature to a sample of older
adults, our study evinces support for a negative association between mindfulness disposition and perceived stress within this
cohort.
Although much has been studied in terms of the associations
between mindfulness and improved psychological health and its
stress-reducing effects, increasing effort is being directed at
understanding the mechanisms through which mindfulness is
associated with a range of benefits. Our findings highlight the
idea that emotion regulation plays a central role in the relationship between mindfulness and stress. Previous research lends
support to this concept of emotional regulation acting as an
underlying mechanism of mindfulness. Dispositional mindfulness has been correlated with less difficulty in regulating emotions (Hill & Updegraff, 2012), with individual differences in
trait mindfulness associated with several facets of emotional
regulation such as emotional reactivity (Arch & Craske, 2010),
emotional differentiation (Hill & Updegraff, 2012), and use of
reappraisal strategies (Desrosiers, Vine, Klemanski, & NolenHoeksema, 2013). In addition, Garland et al., 2011 found that
after the completion of an 8-week mindfulness intervention,
dispositional mindfulness significantly increased whereas perceived stress significantly decreased; increases in positive reappraisal were found to partially mediate this relationship in a
population of community-dwelling middle-age adults. Furthermore, a central feature of a proposed theoretical framework of
mindfulness by Hölzel et al. (2011) involves emotion regulatory
processes, which facilitate nonreactivity to present-moment
sensations—an important principle of mindfulness.
Consistent with this literature, when we examined the results
of our study in the context of emotional regulation and perceived stress, we found evidence for emotion regulation to
mediate the association between dispositional mindfulness and
perceived stress in older and young adults. Providing data to the
theoretical models that propose emotional regulation as a key
component underlying the psychological health benefits associated with mindfulness, our study affords support for higher
perceived emotion regulation abilities to fully mediate the
stress-reducing benefits of mindfulness. From a developmental
perspective, our cross-sectional data support the idea that the
perceived ability to engage in emotion regulation in older age
seems to confer a range of health benefits, including explaining
the association between mindfulness and stress. Future research
would benefit from a RCT using measures of emotional regulation abilities to directly assess the changes in these abilities as
a function of participating in a mindfulness training program.
However, contrary to our hypothesis, we did not find evidence
for an age-related moderation of these effects. Specifically, given
that older adults not only show intact capacities to engage in
emotion regulation, but they also show a chronic activation of
emotion regulatory needs, such that prioritizing goals of emotional
well-being seem to take precedence over the horizon-broadening
goals of young age (Carstensen, Isaacowitz, & Charles, 1999), we
hypothesized a stronger association among dispositional mindfulness, perceived stress, and emotion regulation in older compared
with young adults. Emotion regulation was found to fully mediate
the association between dispositional mindfulness and stress in
both cohorts, suggesting the critical importance of this component
in the theoretical conceptualization of mindfulness. In this study,
we used self-report measures of emotion regulation abilities, and
although young adults endorsed greater difficulties with emotion
regulation and increased thought suppression, it would be interesting for future research to examine how age-related differences
in other facets of emotion regulation, such as the frequency and
variability of emotion regulation strategy use, are associated with
mindfulness and levels of perceived stress.
Just as older adults exhibit a particular trajectory in terms of
emotional regulation, they also exhibit a specific, inverse trajectory related to cognitive control, such that one’s ability to
perform fluid tasks related to working memory, inhibitory control, and set-shifting decline with age (Park & Reuter-Lorenz,
2009). However, contrary to our hypotheses, our study did not
find any significant relationship between cognitive control and
stress, and between cognitive control and mindfulness, in older
or young adults. Although cognitive control has also been
postulated as another key component of the theoretical models
of mindfulness (Hölzel et al., 2011), the empirical data linking
mindfulness to improvements in cognitive control have been
mixed. Within older adults, Moynihan et al. (2013) recently
published the largest RCT of mindfulness training with older
adults. Comparing the efficacy of mindfulness training, relative
to a wait-list control group, they found evidence for a small
improvement on the Trails Making Test; however, these effects
were not maintained at follow-up.
Other studies, particularly involving young adults or community
samples, have provided evidence for an improvement in cognitive
control abilities after engagement in a mindfulness program. For
example, Jha et al. (2007) reported improvements in attentional
orienting after an 8-week MBSR mindfulness training program
relative to a wait-list control. Another study, which involved
undergraduate students, reported improvements in selective attention after completing a 5-day meditation period (Tang et al., 2007).
In addition, working memory improvements as a consequence of
mindfulness training were also reported in young adults, with
increased mindfulness practice time related to greater working
memory capacity (Jha et al., 2010; Zeidan, Johnson, Diamond,
David, & Goolkasian, 2010). However, in contrast to these findings, Anderson et al. (2007) reported no improvements in setshifting, sustained attention, object detection, or inhibitory control
after participation in an 8-week MBSR program.
In addition, and more pertinent to the current study, crosssectional studies, investigating the association between mindfulness disposition and cognitive control are more limited. In a
sample of early adolescents, increased mindfulness disposition
levels, indicated by higher scores on the MAAS, significantly
predicted greater percentage accuracy scores on the computerized
Dots task, a test of inhibitory control (Oberle et al., 2011). Increased mindfulness disposition levels were also associated with
increased cognitive control, measured using tasks of working
memory, temporal-order, and inhibitory control, in a sample of
college-aged students (Anicha et al., 2012).
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MINDFULNESS AND STRESS
Extending this literature, our study examined associations between dispositional mindfulness and various cognitive control
abilities in older and young adults. We assessed the multifaceted
construct of cognitive control by administering computerized measures of working memory, inhibitory control, and set-shifting. For
each of these measures, we calculated performance costs associated with maintaining and manipulating higher cognitive load
relative to a less challenging condition. The lack of significant
associations between dispositional mindfulness and the performance costs for older and young adults was contrary to our
expectations and provides important guidelines for future research.
First, as discussed above, although there is promising support for
improvement of cognitive control abilities after an intervention
program, few studies have cross-sectionally examined if individual
differences in trait mindfulness are associated with metrics of
cognitive control. It would certainly be important for future research in this area to examine if cognitive control abilities of older
adults do in fact change as a function of participating in a longitudinal training program of mindfulness practices. In addition, at
least in the n-back task, whereas older adults showed higher
accuracy costs than young adults, they demonstrated lower RT
costs, suggesting a possible speed-accuracy tradeoff. Future studies would benefit from using nuanced computational models that
combine RT data and accuracy scores, such as diffusion models
(Ratcliff & McKoon, 2008), to clearly delineate the role of various
facets of information processing and decisional processes.
There were a few limitations to note about this current study. As
stated previously, this is a correlational study examining only
relationships at one point in time. Although mediational analyses
were conducted to examine the hypotheses of interest, causal
interpretations of these mediational analyses cannot be made. To
truly determine whether there are certain directionalities and underlying mechanisms of mindfulness, the best mode of study
would be to conduct a RCT investigating the influence of mindfulness training relative to an active control group in reducing
stress in older adults. Another important limitation of the study
was the assessment of dispositional mindfulness and emotion
regulation using self-report measures, suggesting that the shared
methodology of self-report could be an alternative explanation of
the observed effects. It would be important for future studies to
replicate these findings using behavioral measures of emotion
regulation.
Overall, our study contributes to the understanding of mindfulness and its associated benefits in several ways. First, by
focusing on older adults, this study adds to the increasing, but
limited database of studies examining the benefits conferred by
mindfulness in an aging cohort (Gallegos, Hoerger, Talbot,
Moynihan, & Duberstein, 2013; Moynihan et al., 2013;
Prakash, De Leon, Klatt, Malarkey, & Patterson, 2013; Raes et
al., 2013). Second, by simultaneously examining cognitive control and emotional regulation, we were able to provide evidence
for emotional regulation abilities, but not cognitive control, to
play a significant role in the mindfulness-based positive associations within older adults. In addition, our study involved a
comprehensive assessment of cognitive control abilities using
measures that tap into the three facets of cognitive control as
outlined by Miyake et al., 2000.
169
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Received May 23, 2014
Revision received October 13, 2014
Accepted November 14, 2014 䡲