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

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.

KEYWORDS:

• Dissociation
• PTSD
• Mindfulness
• Attention
• Emotion regulation

Disclosure statement

No potential conflict of interest was reported by the author(s).

Authors’ contributions

All authors contributed to the study conception and design. All authors gathered the data and contributed to the proofreading of the manuscript. The first and last authors performed statistical analysis and wrote the first version of the manuscript.

Data availability statement

The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.

Ethical approval and consent to participate

The experiment and informed consent procedures were approved by the ethics committee of the University (Comité d’Ethique de la Recherche Tours-Poitiers. number 2019-02-01).

Additional information

Funding

This work did not receive any specific grant from funding agencies from the public, commercial, or not-for-profit sectors.