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Does mindfulness training make thinking more flexible, and how?

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An eight-week mindfulness course made stressed adults more cognitively flexible than a waitlist group, and this benefit ran through learning not to react to their own thoughts and feelings.

Source

The Mediating Role of Non-reactivity to Mindfulness Training and Cognitive Flexibility: A Randomized Controlled Trial

Zou Y, Li P, Hofmann SG, et al. · Frontiers in psychology · 2020

doi.org/10.3389/fpsyg.2020.01053Read the full paper ↗31 citationscc by

Study at a glance

Design
RCT — Stratified randomisation to 8-week MBSR or waitlist; mindfulness facets measured at baseline, week 3, week 6 and post-treatment; bootstrapped mediation models.
N
N=54 · 54 randomised (26 MBSR, 28 waitlist) and analysed by intention-to-treat with imputation; six MBSR and five waitlist participants dropped out.
Population
Stressed but non-clinical adults in Beijing (mostly women, highly educated) with no prior MBSR/MBCT experience
Outcome
Cognitive Flexibility Inventory (post-treatment); perceived stress; Five Facet Mindfulness Questionnaire facets as mediators

Structured fields used in claim comparison tables when every cited study has a complete layer.

What they did

Stressed adults without a psychiatric diagnosis were randomly assigned to an eight-week Mindfulness-Based Stress Reduction (MBSR) course or a waitlist control, 54 people in total. Participants filled in questionnaires on mindfulness facets, cognitive flexibility and perceived stress before training, at week 3, at week 6 and after the course. The researchers tested whether changes in two mindfulness skills, non-reactivity and non-judgment, measured during the course, explained the post-course change in cognitive flexibility.

What they found

Both groups improved in cognitive flexibility, but the MBSR group scored higher than the waitlist group after training (a medium-sized group-by-time effect). Non-reactivity grew faster in the MBSR group, and non-reactivity at week 6 fully mediated the training effect on flexibility, accounting for 53.94% of the total effect; week 3 non-reactivity and non-judgment at either time did not mediate. Surprisingly, perceived stress fell just as much in the waitlist group, so MBSR showed no extra stress reduction.

The limits

What it doesn't show

The sample was small, mostly female and highly educated, so power was limited (the week 6 mediation had estimated power of 0.69) and generalisation is uncertain. A no-treatment waitlist cannot separate mindfulness-specific effects from attention, expectation or group contact, and participants were not blind. All measures were self-report, and cognitive flexibility was a questionnaire rather than a behavioural task; home practice time was not recorded.

Key terms

MBSR
Mindfulness-Based Stress Reduction, a standardised eight-week group course of meditation and mindful awareness practices.
Non-reactivity
A mindfulness facet: noticing thoughts and feelings without having to act on or change them.
Cognitive flexibility
Here, the self-rated ability to see difficult situations as controllable and to generate alternative explanations and solutions.
Mediation
A test of whether an intervention works through an intermediate variable, estimated as the product of the path to the mediator and the path from mediator to outcome.
Waitlist control
A comparison group that receives no intervention during the study but is offered it afterwards.

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Which variable fully mediated MBSR's effect on cognitive flexibility?

Common questions

Why measure mindfulness at weeks 3 and 6?

A mediator must change before the outcome does; measuring during the course lets the researchers check that non-reactivity improved before post-course flexibility was measured.

Why didn't stress drop more in the MBSR group?

The waitlist group's stress also fell sharply, perhaps through natural decline or self-help, and the stress scale focused on appraisals rather than physical stress symptoms.

Does this prove non-reactivity causes flexibility?

It is strong evidence within a randomised design, but mediators themselves were not manipulated, the sample was small and both were self-reported, so the causal chain is suggestive.

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