Mindfulness, acceptance, and emotion regulation: perspectives from Monitor and Acceptance Theory (MAT)

doi:10.1016/j.copsyc.2018.12.004

Current Opinion in Psychology

Volume 28, August 2019, Pages 120-125

https://doi.org/10.1016/j.copsyc.2018.12.004 Get rights and content

Highlights

•
Experiential acceptance is described as a central feature of mindfulness interventions.
•
Based on theory and correlational research, MAT posits that acceptance is a key emotion regulation mechanism.
•
Dismantling trials show that acceptance is a key ingredient of mindfulness interventions.
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Emphasizing acceptance skills may maximize the efficacy of mindfulness interventions.

Experiential acceptance—an orientation of receptivity and noninterference with present-moment experiences—is described as central to mindfulness interventions, yet little experimental work has tested acceptance as a mechanism for mindfulness intervention effects. Guided by Monitor and Acceptance Theory (MAT), this review situates acceptance as an emotion regulation mechanism and reviews self-report mindfulness literature showing that attention monitoring skills are only associated with beneficial mental and physical health outcomes when accompanied by acceptance skills. New experimental dismantling work shows that removing acceptance training from mindfulness interventions reduces their efficacy for improving stress, positive emotion, and social relationship outcomes. Overall, converging evidence demonstrates that acceptance is a critical emotion regulation mechanism of mindfulness interventions. This work advances basic research, has translational value, and offers opportunities for future research.

Section snippets

MAT: acceptance as an emotion regulation mechanism

Prominent theoretical models identify emotion regulation as a central mechanism for the effects of mindfulness on mental and physical health outcomes, acting to reduce affective and physiological reactivity and promote recovery [7]. And indeed, meta-analytic evidence shows that emotion regulation processes mediate the effects of mindfulness interventions on improvements in mental health [8]. In contrast, ineffective emotion regulation is a core feature of psychopathology [9], and a growing body

Testing MAT: dismantling acceptance from mindfulness interventions

To test whether learning acceptance skills is a critical emotion regulation mechanism of mindfulness interventions for improving affective, stress, and social relationship outcomes, recent studies have employed intervention dismantling designs. Dismantling designs have been recommended and used to identify active treatment elements of multi-component mindfulness interventions [34,35]. We have adopted this experimental approach to test whether removing acceptance skills training from mindfulness

MAT insights, revisions, and future directions

We reviewed evidence that trait acceptance skills moderate the link between present-focused attention monitoring and poor emotional, social, and health functioning, and that removing acceptance training from mindfulness interventions reduces their efficacy for improving stress, positive emotion, and social relationship outcomes. Together, recent evidence suggests that acceptance is a critical emotion regulation mechanism of mindfulness interventions.

Yet further work is needed to directly test

Conclusions

Accumulating evidence shows that experiential acceptance is a critical component of mindfulness interventions for improving affective, stress, and social relationship outcomes. This work advances basic research on the mechanisms of mindfulness, has translational value for maximizing the efficiency and impact of mindfulness interventions, and offers exciting opportunities for future research.

Conflict of interest statement

Nothing declared.

References and recommended reading

Papers of particular interest, published within the period of review, have been highlighted as:

• of special interest
•• of outstanding interest

Acknowledgements

This work was supported by grants from the National Center for Complementary and Integrative Health (NCCIH) of the National Institutes of Health (F32AT009508, R21AT008493, and R01AT008685). We thank Anna Marsland for helpful comments on an early draft.

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Trait Mindfulness in Psychotic Disorders: Dimensions Predicting Symptoms, Cognition, and Functional Outcome
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Mindfulness-based treatments are efficacious for psychotic disorders (PD). However, which components of mindfulness (i.e., attentive monitoring and nonjudgmental acceptance) are most relevant treatment targets is unclear. Further, there is a dearth of literature examining clinical correlates of mindfulness in people with PD. The present study aimed to examine group differences and clinical correlates of mindfulness in people with PD. We hypothesized that PD would report lower monitoring and acceptance than CN and that mindfulness components would be associated with symptoms including dysfunctional beliefs, alexithymia, neurocognitive ability, positive symptoms, and mood symptoms. Groups included individuals with PD (n = 54) and nonpsychiatric controls (n = 55). Participants completed self-report measures of mindfulness and related constructs and clinical interviews of symptoms. Results of ANOVA models indicated that global mindfulness was lower in PD relative to CN, with greatest differences evident for acceptance in the affective psychosis group. Regression models found that greater monitoring was associated with improved neurocognitive performance, while acceptance was associated with lower defeatist beliefs, alexithymia, and depression/anxiety symptoms. Results highlight the importance of targeting acceptance in the psychosocial treatment of PDs, especially for those with mood symptoms.
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PROMIS Physical Function was directly and weakly correlated with walking speed (ρ = 0.26, 2-min walk) and inversely and weakly correlated with lower extremity strength (ρ = −0.29, 5x sit-to-stand). RMDQ was not correlated with any of the capacity-based measures. PROMIS Physical Function was inversely and moderately correlated with Pain Interference (ρ = −0.48) and Pain Behavior (ρ = −0.43), PCS ( $ρ$ = −0.36), and FABQ ( $ρ$ = −0.31). The RMDQ was strongly correlated with PROMIS Physical Function (ρ = −0.56), Pain Behavior (ρ = 0.51) and Pain Interference (ρ = 0.49); and moderately correlated with PCS (ρ = 0.37) and FABQ (ρ = 0.33). PROMIS Physical Function and RMDQ were not correlated with CPAQ. Lower scores on PROMIS Physical Function were weakly associated with lower measures of lower extremity strength (−0.30, 95% CI: −0.51 to −0.09, p = 0.005). Higher scores on RMDQ were also weakly associated with lower measures of lower extremity strength (0.26, 95% CI: 0.11 to 0.41, p = 0.001).
A strong association emerged between self-reported limitations in physical function, pain behavior, and pain interference. A weak association emerged between self-reported physical function and lower extremity strength.
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View full text

Mindfulness, acceptance, and emotion regulation: perspectives from Monitor and Acceptance Theory (MAT)

Highlights

Section snippets

MAT: acceptance as an emotion regulation mechanism

Testing MAT: dismantling acceptance from mindfulness interventions

MAT insights, revisions, and future directions

Conclusions

Conflict of interest statement

References and recommended reading

Acknowledgements

Behav Ther

Clin Psychol Rev

Behav Res Ther

J Affect Disord

J Behav Ther Exp Psychiatry

Clin Psychol Sci Pract

Soc Cogn Affect Neurosci

Mindfulness

Emotion

Front Psychol

Emotion

Psychol Inq

Clin Psychol Sci

J Clin Psychol

Mindfulness: a proposed operational definition

Clin Psychol Sci Pract

Moving beyond mindfulness: defining equanimity as an outcome measure in meditation and contemplative research

Mindfulness

What is mindfulness? A contemplative perspective

The decoupling model of equanimity: theory, measurement, and test in a mindfulness intervention

Mindfulness

Mechanisms of mindfulness training: Monitor and Acceptance Theory (MAT)

Clin Psychol Rev

How does mindfulness meditation work? Proposing mechanisms of action from a conceptual and neural perspective

Perspect Psychol Sci

Emotion-regulation strategies across psychopathology: a meta-analytic review

Clin Psychol Rev

Experiential avoidance as a functional dimensional approach to psychopathology: an empirical review

J Clin Psychol

Distress tolerance and psychopathological symptoms and disorders: a review of the empirical literature among adults

Psychol Bull

Acceptance and commitment therapy, relational frame theory, and the third wave of behavioral and cognitive therapies

Behav Ther

Trait mindfulness predicts efficient top-down attention to and discrimination of facial expressions

J Pers

Selective attentional bias towards pain-related threat in fibromyalgia: preliminary evidence for effects of mindfulness meditation training

Cogn Ther Res

The conditional process model of mindfulness and emotion regulation: an empirical test

J Affect Disord

Getting personal with mindfulness: a latent profile analysis of mindfulness and psychological outcomes

Mindfulness