Mindfulness May Be a Mediator of Anxiety When Responding to an Uncertain Threat

The relationship between mindfulness and anxiety may involve reactions to uncertainty. These findings were published in the Journal of Anxiety Disorders.

Students (N=55) at the University of Groningen in the Netherlands were recruited to participate in this study. The participants were assessed for panic, social anxiety, worry, obsessive compulsive symptoms, mindfulness, and uncertainty by a questionnaire and tested by the threat-of-shock task (NPU-threat test).

During the NPU-threat test, prompts on a computer screen indicated that no shock, predictable shocks, or unpredictable shocks would be administered through electrodes attached to the left hand. Reactions to the shocks were assessed by 2 questions following the prompts and by electrodes for facial electromyography.

Participants were mostly women (n=32) who were aged mean 23.25 (standard deviation [SD], 3.87) years. Participants received financial compensation (n=48) or they participated to fulfill a program requirement (n=7).

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During the NPU-threat test, condition (F[294], 105.43; P .001; hp2, .692), cue (F[147], 80.256; P .001; hp2, .631), and the interaction between the 2 (F[1.589,74.691], 50.091; P .001; hp2, .516) were significant for startle magnitude and subjective anxiety.

Compared with the no shock condition, both predictable (P =.001) and unpredictable (P .001) shock conditions elicited a greater startle magnitude.

Anxiety differed significantly during condition (F[1.666,78.287], 94.152; P .001; hp2, .667) in which anxiety was greater during predictable (P .001) and unpredictable (P .001) shock conditions compared with the no shock treatment. Anxiety was highest during the unpredictable shock condition (P .001).

Five Facet Mindfulness Questionnaire (FFMQ) scores were inversely related with all measures of anxiety (range, -.27 to -.67; all P .05) and intolerance and uncertainty (range, -0.53 to -0.61; all P .05). Measures of intolerance and uncertainty were positively associated with all anxiety measures (range, .29-.66; all P .05) except for interoceptive fear (range, .01-.14; P =.30).

FFMQ scores were not associated with response to uncertainty (r, -.176; P =.232) or startle (r, .073; P =.622).

Mindfulness mediation was observed to have a significant direct effect on social anxiety (-.592; SD, .121; P .01), agoraphobia (-.256; SD, .094; P .01), and worry (-.434; SD, .120; P .01) but not on obsessive compulsive symptoms (.066; SD, .103).

These results may have been biased by the small sample size, especially because the investigators reported a high amount of response variability of the psychophysiological measures.

This study was the first to find a relationship of uncertainty with mindfulness and anxiety, indicating mindfulness may be an important therapeutic tool across multiple psychological disorders. Future studies are needed to confirm this relationship between mindfulness and anxiety.


Papenfuss I, Lommen MJJ, Grillon C, Balderston NL, Ostafin BD. Responding to uncertain threat: A potential mediator for the effect of mindfulness on anxiety. J Anxiety Disord. 2020;77:102332. doi:10.1016/j.janxdis.2020.102332