Disentangling the Link Between Mindfulness and Dissociation in PTSD: The Mediating Role of Attention and Emotional Acceptance

Mindfulness abilities are linked to dissociation in people with PTSD, and the relationship is mediated by emotional non-acceptance and attentional difficulties. In a sample of 90 patients with PTSD, those with more severe dissociative symptoms reported lower mindfulness capacity. Statistical analysis showed that mindfulness indirectly reduced dissociation through improved emotional acceptance and attention, supporting a model where these two components are active mechanisms of mindfulness. The findings suggest mindfulness-based interventions might help treat dissociation, but clinical trials are needed to confirm causality.

Study at a glance

Abstract

ABSTRACT Introduction A number of studies have investigated the relationship between mindfulness and dissociation and suggested that mindfulness-based interventions could be effective in the treatment of dissociative symptoms. A recent study in healthy volunteers found that attention and emotional acceptance mediates this relationship. However, no study has yet been performed among a clinical sample to assess this association. Method We recruited 90 patients (76 women) suffering from Posttraumatic Stress Disorder (PTSD). They completed self-report questionnaires to measure PTSD, dissociation, emotion regulation difficulties, childhood trauma, mindfulness abilities and cognitive abilities. Results We found that mindfulness abilities, emotional difficulties, dissociation and attention-concentration were all related to each other. Using a step-by-step approach and bootstrapping techniques, we found a significant indirect effect of mindfulness abilities on dissociation through non-acceptance (confidence interval 95%=-.14 to −.01) and attentional difficulties (confidence interval 95%=-.23 to −.05). Conclusion Patients with higher levels of dissociative symptoms have less capacity for mindfulness. Our results support Bishop et al.’s model proposing that attention and emotional acceptance are the two active components of mindfulness. To extend our findings, clinical trials are required to evaluate a causal relationship and the effectiveness of mindfulness-based interventions for patients suffering from dissociation.