An eight-week mindfulness-based stress reduction (MBSR) workshop increases regulatory choice flexibility

Reciprocal effects between negative affect and emotion regulation in daily life

The extended process model of emotion regulation provides a framework for understanding how emotional experiences and emotion regulation (ER) mutually influence each other over time. To investigate this reciprocal relationship, 202 adults completed a ten-day experience-sampling survey capturing levels of negative affect (NA) experience and use of ten ER strategies in daily life. Residual dynamic structural equation models (DSEMs) were used to examine within-person cross-lagged and autoregressive effects of NA and ER (strategy use and between-strategy variability). Results showed that NA predicted lower between-strategy variability, lower subsequent use of acceptance and problem-solving, but higher subsequent use of rumination and worry. Moreover, reappraisal and between-strategy variability predicted lower subsequent NA levels, while expressive suppression and worry predicted higher subsequent NA levels. Stable autoregressive effects were found for NA and for maladaptive ER strategies (e.g., rumination and worry). Exploratory correlation analyses revealed positive associations between NA inertia and maladaptive ER strategies. Together, these findings provide evidence of a dynamic interplay between NA and ER. This work deepens how we understand the challenges of applying ER strategies in daily life. Future clinical and translational research should consider these dynamic perspectives on ER and affect.

Managing emotions in the age of political polarization: A randomized controlled trial comparing mindfulness to cognitive reappraisal

Emotional appraisals of political stimuli (e.g., videos) have been shown to drive shared neural encoding, which correspond to shared, yet divisive, interpretations of such stimuli. However, mindfulness practice may entrain a form of emotion regulation that de-automatizes social biases, possibly through alteration of such neural mechanisms. The present study combined a naturalistic neuroimaging paradigm and a randomized controlled trial to examine the effects of short-term mindfulness training (MT) (n = 35) vs structurally equivalent Cognitive Reappraisal training (CT) (n = 37) on politically-situated emotions while evaluating the mechanistic role of prefrontal cortical neural synchrony. Participants underwent functional near-infrared spectroscopy (fNIRS) recording while viewing inflammatory partisan news clips and continuously rating their momentary discrete emotions. MT participants were more likely to respond with extreme levels of anger (odds ratio = 0.12, p < .001) and disgust (odds ratio = 0.08, p < .001) relative to CT participants. Neural synchrony-based analyses suggested that participants with extreme emotion reactions exhibited greater prefrontal cortical neural synchrony, but that this pattern was less prominent in participants receiving MT relative to CT (CT > MT; channel 1 ISC = .040, p = .030).

Age differences in emotion regulation strategy use and flexibility in daily life

OBJECTIVES

Age-related shifts in emotion regulation patterns are important for explaining preserved emotional well-being in late adulthood amidst declines in physical and cognitive health. Although several studies have examined age-related shifts in emotion regulation strategy use, age differences in how specific strategies are flexibly adapted to shifting contexts in daily life and the adaptiveness of such shifts remains poorly understood.

METHODS

130 younger adults (ages 22-35) and 130 older adults (ages 65-85) completed a modified Day Reconstruction Method Assessment and self-report questionnaires to examine age differences in emotion regulation strategy use and one aspect of emotion regulation flexibility (responsiveness) in daily life, and the adaptive implications of these differences.

RESULTS

Older adults exhibited more frequent acceptance use, less frequent distraction use, and less flexibility in the responsiveness of strategies with varying negative affect. Across age groups, the use of expressive suppression and distraction was associated with less adaptive outcomes, whereas higher acceptance responsiveness, positive reappraisal responsiveness, and situation selection responsiveness were associated with more adaptive outcomes. Age-group moderated the associations between adaptiveness metrics with the use and flexibility of several emotion regulation strategies.

CONCLUSION

The current findings provide early evidence of age-related decreases in emotion regulation flexibility as well as age-related shifts in the adaptiveness of emotion regulation patterns.

The Costs and Benefits of Mindfulness and Reappraisal in Daily Life

Reappraisal and mindfulness represent two fundamentally different but interconnected ways of dealing with one's emotions: whereas reappraisal is aimed at changing one's thoughts and emotions, mindfulness is aimed at not immediately changing, but appreciating them. Despite this difference, prior research has shown that both are beneficial for one's affective well-being. However, research on the spontaneous use of reappraisal and mindfulness in daily life found that they might be differentially associated with positive and negative affect, with reappraisal and mindful attention being more strongly associated with increased positive affect and mindful acceptance with decreased negative affect. Moreover, the spontaneous use of reappraisal may be less effective than mindfulness in daily life given that it is more cognitively taxing. To compare these possibly different benefits (i.e., change in positive and negative affect) and costs (i.e., feeling depleted), we re-analyzed two experience sampling studies (N = 125 and N = 179). Regarding benefits, endorsing reappraisal and mindful attention was significantly associated with increases in positive affect, whereas endorsing mindful acceptance was significantly associated with decreases in negative affect. Regarding costs, we found that endorsing reappraisal led to more depletion and that reappraisal was selected less often than mindfulness in daily life. Our results demonstrate the importance of assessing not only the different benefits but also the costs of emotion regulation in daily life.

Supplementary Information

The online version contains supplementary material available at 10.1007/s42761-022-00178-7.

Risk and resilience factors associated with college students' psychological distress and PTSD symptoms during the COVID-19 pandemic

Objective: College students are experiencing pronounced mental health difficulties as a result of the COVID-19 pandemic. Little is known, however, about underlying risk and resilience factors contributing to students' psychological health during this time. The current study examined mindfulness, resilience, coping, emotion regulation, and daily hassles as possible predictors of COVID-19 concern, psychological distress, and PTSD symptoms in a sample of college students. Participants: One hundred and thirty-five undergraduate college students participated in this study during the COVID-19 pandemic. Methods: Participants completed a series of self-report questionnaires. Results: Risk and resilience factor hierarchical regression models were run separately to predict the three outcomes. Daily hassles, ethnicity, and first-generation college student status predicted greater COVID-19 concern; daily hassles and difficulties with emotion regulation predicted greater psychological distress; daily hassles, difficulties with emotion regulation, avoidant coping, and problem-focused coping positively predicted PTSD symptoms. Acting with awareness mindfulness and continuing-generation college student status predicted lower COVID-19 concern; acting with awareness mindfulness, nonjudging mindfulness, and resilience predicted lower psychological distress; acting with awareness mindfulness, nonjudging mindfulness, and resilience also predicted lower PTSD symptomatology. Conclusions: Identifying underlying factors associated with college students' mental health during the COVID-19 pandemic may facilitate the development and implementation of targeted preventative interventions aimed at promoting well-being in this uniquely vulnerable population.

Web-based training for post-secondary student well-being during the pandemic: a randomized trial

Background: The COVID-19 pandemic has been a highly stressful period where post-secondary education moved to online formats. Coping skills like decentering and reappraisal appear to promote stress resilience, but limited research exists on cultivating these skills in online learning contexts.Methods: In a three-arm randomized trial design, we evaluated three-week, web-based interventions to gauge how to best cultivate mindfulness and stress-reappraisal skills and whether the proposed interventions led to improved mental health. Undergraduate participants (N = 183) were randomly assigned to stress mindset, mindfulness meditation, or mindfulness with choice conditions.Results: At the study level (baseline vs. post-intervention), decentering improved across all conditions. Mindfulness with choice significantly decreased negative affect and rumination compared to stress mindset, while stress mindset significantly enhanced stress mindset skills compared to both mindfulness groups. At the daily level (three sessions per week), stress mindset significantly increased positive affect compared to mindfulness meditation.Conclusions: Results suggest that student mental health can be remotely supported through brief web-based interventions. Mindfulness practices seem to be effective in improving students' negative mood and coping strategies, while stress mindset training can help students to adopt a stress-is-enhancing mindset. Additional work on refining and better matching students to appropriate interventions is needed.

Trait mindfulness and emotion regulation responsiveness to negative affect in daily life

Objectives

Recent conceptualizations of adaptive emotion regulation is predicated on the ability to flexibly use emotion regulation strategies to meet changing contextual demands. Although trait mindfulness has been linked to enhanced emotional well-being and use of adaptive emotion regulation strategies, there is a dearth of literature examining associations between trait mindfulness and emotion regulation flexibility. Further, despite a rich literature suggesting that emotion regulation processes change with age, no study to date has assessed whether the role of trait mindfulness on emotion regulation responsiveness to negative emotions-a component of emotion regulation flexibility-differs between young and older adults.

Methods

The current study recruited 130 young adults and 130 older adults to assess trait mindfulness, emotion regulation strategy use, and emotion regulation responsiveness of six distinct strategies in daily life.

Results

Across the full sample, trait mindfulness was related to reduced distraction (β = -0.11, t(238.09) = -3.02, p = .003) and expressive suppression (β = -0.15, t(237.70) = -4.62, p < .001) strategy use. Age moderation analyses revealed that trait mindfulness was associated with reduced expressive suppression responsiveness (β = 0.12, t(247) = 2.31, p = .022) in young adults and increased detached reappraisal responsiveness among older adults (β = 0.15, t(247) = -2.95, p = .003).

Conclusions

The current findings highlight the importance of understanding how trait mindfulness is associated with strategy use and responsiveness to negative affect changes in daily life as well as how these patterns may shift across the lifespan.

Manuscript Pre-registration

Open Science Framework, registration number: z5g8v.

Steady-state visual evoked potentials differentiate between internally and externally directed attention

While attention to external visual stimuli has been extensively studied, attention directed internally towards mental contents (e.g., thoughts, memories) or bodily signals (e.g., breathing, heartbeat) has only recently become a subject of increased interest, due to its relation to interoception, contemplative practices and mental health. The present study aimed at expanding the methodological toolbox for studying internal attention, by examining for the first time whether the steady-state visual evoked potential (ssVEP), a well-established measure of attention, can differentiate between internally and externally directed attention. To this end, we designed a task in which flickering dots were used to generate ssVEPs, and instructed participants to count visual targets (external attention condition) or their heartbeats (internal attention condition). We compared the ssVEP responses between conditions, along with alpha-band activity and the heartbeat evoked potential (HEP) - two electrophysiological measures associated with internally directed attention. Consistent with our hypotheses, we found that both the magnitude and the phase synchronization of the ssVEP decreased when attention was directed internally, suggesting that ssVEP measures are able to differentiate between internal and external attention. Additionally, and in line with previous findings, we found larger suppression of parieto-occipital alpha-band activity and an increase of the HEP amplitude in the internal attention condition. Furthermore, we found a trade-off between changes in ssVEP response and changes in HEP and alpha-band activity: when shifting from internal to external attention, increase in ssVEP response was related to a decrease in parieto-occipital alpha-band activity and HEP amplitudes. These findings suggest that shifting between external and internal directed attention prompts a re-allocation of limited processing resources that are shared between external sensory and interoceptive processing.

Emotion Regulation, Stress, and Well-Being in Academic Education: Analyzing the Effect of Mindfulness-Based Intervention

Recent studies point to an increase in psychological distress among graduate students. The aim of this study was to analyze the effects of mindfulness practices on emotion regulation, on the perception of stress, and on the psychological well-being of graduate students. Forty-five (45) graduate students participated in the study, divided into an intervention and a control group. Questionnaires were applied for self-assessment of mindfulness, perceived stress, and psychological well-being, in addition to qualitative interviews in the pre- and post-timeframes of a mindfulness-based intervention. Quantitative data were analyzed using ANOVAs for repeated measures, while the interviews were analyzed using the thematic content analysis technique. The results indicated increases in the levels of mindfulness and psychological well-being, and a reduction in perceived stress in the intervention group, post-intervention. The interviews indicated the presence of ambivalent emotions in relation to graduate studies and the development of new strategies to cope with the stress in this work context. The main contribution of the study was to present empirical evidence of the effectiveness of mindfulness practices in the graduate-level education context, allowing students to become more capable of dealing with the challenges of an academic career.

Mindfulness-Based Stress Reduction Increases Mental Wellbeing and Emotion Regulation During the First Wave of the COVID-19 Pandemic: A Synchronous Online Intervention Study

The COVID-19 pandemic imposed extreme living conditions of social distancing, which triggered negative mental health problems and created challenges in seeking mental health support. Mindfulness-based interventions (MBIs) have been found to enhance wellbeing and mental health by reducing stress and anxiety and improving emotion regulation. Preliminary evidence suggests that online, synchronous MBIs may produce beneficial effects similar to face-to-face programs. However, the effectiveness of such online-MBIs to support mental health in highly stressful times, such as a global pandemic, requires further study. To this end, we investigated the effect of an online 8-week Mindfulness-Based Stress Reduction (MBSR) program on aspects of mental health during the first wave of the COVID-19 pandemic. Participants (N=92) who expressed interest in discounted online-MBSR programs were recruited for the study. The division into experimental and control groups was based on actual enrollment to the courses. Those who enrolled in a program were assigned to the experimental condition and those who decided not to enroll served as controls. Participants were assessed pre-intervention, post-intervention, and 1-month post-intervention for levels of mindfulness, perceived stress, anxiety, emotion regulation, and intolerance of uncertainty. Differences between the groups were tested using the general linear mixed effects model (GLMM) and Individual Growth Curve Models (IGCM) in intent to treat analysis. The findings indicated that, relative to the control group, MBSR improved mindfulness abilities (p <0.001), decreased anxiety (p <0.001), and stress (p <0.001) and increased emotion regulation (p <0.001). These effects were found to persist 1 month after the end of the program, despite the increased governmental public-health restrictions due to COVID-19 at that time. The ability to tolerate uncertainty, a central characteristic of the pandemic, was not found to be affected by the program. A mediation analysis revealed that the effect of the intervention on mental health improvement was partially mediated by the improvement in emotion regulation. Overall, the findings provide positive evidence for the feasibility of an online-MBSR program to support the mental health of individuals from the general population through the mediation of emotion regulation in challenging times, such as a global pandemic.

Mindfulness-Based Interventions for Undergraduate Nursing Students in a University Setting: A Narrative Review

(1) Introduction: Undergraduate (UG) nursing students are vulnerable to stress throughout their education, known to result in burnout, with high attrition rates of up to 33%. There is a growing body of evidence to suggest that mindfulness-based interventions are effective for the management of anxiety, depression and wellbeing, thereby reducing stress in healthcare provider populations. The aim of this narrative review was to synthesize and provide a critical overview of the current evidence in relation to mindfulness-based interventions for UG nursing students in a university setting. (2) Methods: A review of the literature was conducted in March 2020 and updated in May 2021, utilising the databases CINAHL, Medline and PsycINFO. (3) Results: Fifteen studies were included in the review, with three common themes identified: (i) the positive impact of mindfulness on holistic wellbeing, (ii) mindfulness-based techniques as a positive coping mechanism within academic and clinical practice, and (iii) approaches to the delivery of mindfulness-based interventions. (4) Conclusions: Mindfulness-based interventions are effective strategies for the management of stress, development of self-awareness and enhanced academic and clinical performance in undergraduate nursing students. No ideal approach to delivery or duration of these interventions was evident from the literature. Best practice in relation to delivery of mindfulness-based interventions for nursing students is recommended for future studies.

The Mindfulness Map: A Practical Classification Framework of Mindfulness Practices, Associated Intentions, and Experiential Understandings

When considering the numerous mindfulness-based and mindfulness-informed programs that have flourished in the past decades it is not always clear that they all refer to the same “mindfulness. ” To facilitate more clarity and precision in describing, researching and teaching mindfulness in the secular settings, we propose a classification framework of mindfulness practices, intentions behind them and the experiential understandings the practices may aim to develop. Accordingly, the proposed framework, called the Mindfulness Map, has two axes. The first axis outlines mindfulness practices (and associated instructions) classified into four groups (MGs), e.g. the MG1 focuses on cultivating attention to the present moment somatic and sensory experience while the MG4 focuses on cultivating the ability to recognize and deconstruct perceptual, cognitive and emotional experiences and biases. The second axis outlines possible intentions (INTs) to cultivate particular experiential understanding (EU) via teaching and practicing the MGs, e.g., the INT1 designates the intention to gain EU of how our relationship to experience contributes to wellbeing, the INT2 refers to the intention to gain EU of the changing nature of body, mind and external phenomenon. We suggest that the same MG can lead to different EUs outcomes based on the specific INTs applied in their teaching or practice. The range of INTs and EUs included here is not exhaustive, there are further types the Map could be expanded toward. Aside from encouraging more fine-grained distinctions of mindfulness practices, the proposed Map aims to open discussions about interactions between MGs, INTs, EUs and practice outcomes. The Map may facilitate more nuanced and precise approaches to researching the range of outcomes cultivated by mindfulness practices, help bridge contradictory findings, and catalyze further debate and research into ethical aspects of mindfulness. The Map also highlights the need for further teaching development and research on longer-term trajectories of mindfulness practice. While the proposed Mindfulness Map organises the mindfulness practice territory along two axes, it is aimed as a starting point for further discussion and can be further revised and/or expanded by other axes.

What do people mean when they talk about mindfulness?

Psychological theories cast mindfulness as a form of awareness in which accepting the presence of stressful thoughts and feelings facilitates engaged exploration and identification of adaptive responses. Critics of mindfulness' popularization suggest that lay people misconstrue acceptance as a passive endorsement of experience, undermining engaged problem-solving. To evaluate this criticism, we traced the contemporary semantic meaning of mindfulness in three of the most extensive linguistic corpora of English language and found that general public's depictions of mindfulness highlight engagement-related processes. We further analyzed the nomological network of mindfulness. While mindfulness theories suggest a general convergence of facets representing awareness and acceptance, in a meta-analysis (k = 145; N = 41,966) of the Five Facet Mindfulness Questionnaire only expert- and clinical samples reported convergence, whereas lay people showed absent or even antagonistic associations. Further, contrary to the synergistic model of awareness and acceptance contributing to greater engagement, empirical probes of two lay samples (N_total = 406) show that acceptance is either unrelated or inversely related to markers of engagement. To overcome resulting conceptual and methodological challenges, we highlight the need for a contextualized mindfulness framework whereby acceptance enables the process of engaging with life's challenges rather than avoiding them.

The Effects of Mindfulness-Based Stress Reduction on the Association Between Autonomic Interoceptive Signals and Emotion Regulation Selection

OBJECTIVE

The ability to select the most adaptive regulatory strategy as a function of the emotional context plays a pivotal role in psychological health. Recently, we showed that mindfulness-based interventions (MBIs) can improve the sensitivity of regulatory strategy selection to emotional intensity. However, the mechanisms underlying this improvement are unclear. In this study, we tested the hypothesis that MBIs support adaptive regulatory selection by increasing sensitivity to interoceptive signals associated with the emotional stimuli.

METHODS

Participants (n = 84, mean [standard deviation {SD}] age = 30.9 [8.3] years; 54% women) were randomized to either a mindfulness-based stress reduction (MBSR) program or a wait-list control condition. Before and after the MBSR program, physiological measures for autonomic nervous system activity were obtained, and participants performed a task examining emotion regulation selections (reappraisal versus distraction) when confronted with low or high negative intensity images. They also completed a battery of mindfulness, interoception, and well-being self-report measures. A cross-classified model was used for the main analyses.

RESULTS

The participants assigned to the MBSR were overall more likely to choose reappraisal than distraction (b = 0.26, posterior SD = 0.13, 95confidence interval = 0.02-0.52) after the program. Interoceptive signals in response to negative images were associated with subsequent regulatory selections (b = 0.02, posterior SD = 0.01, 95% confidence interval = 0.01-0.03) in the MBSR group. Specifically, lower cardiac reactivity was associated with the choice to reappraise, whereas higher cardiac reactivity was related to the choice to distract. Greater differences in cardiac reactivity between states that prompt reappraisal and states that prompt distraction were associated with higher well-being (Satisfaction With Life Scale, Pearson r (29) = 0.527, p = .003).

CONCLUSIONS

Mindfulness seems to increase the sensitivity of regulatory selections to interoceptive signals, and this is associated with subjective well-being. This may be a central pathway through which MBIs exert their positive effects on mental health and resilience.

Aptitude and attitude: predictors of performance during and after basic laparoscopic skills training

Background

Manual dexterity and visual-spatial ability are considered key to the development of superior laparoscopic skills. Nevertheless, these abilities do not reliably explain all the variance found in the technical performance of surgical trainees. Consequently, we must look beyond these abilities to improve our understanding of laparoscopic skills and to better identify/develop surgical potential earlier on.

Purpose

To assess the individual and collective impact of physical, cognitive, visual, and psychological variables on performance during and after basic simulation-based laparoscopic skills training.

Method

Thirty-four medical students (laparoscopic novices) completed a proficiency-based laparoscopic skills training program (using either a 2D or 3D viewing mode). This was followed by one testing session, a follow-up testing session with new (yet similar) tasks, and a series of physical, cognitive, visual, and psychological measures.

Results

The statistical models that best predicted variance in training performance metrics included four variables: viewingmode (2D vs 3D), psychologicalflexibility, perceivedtaskdemands, and manualdexterity (bimanual). In subsequent testing, a model that included viewingmode and manualdexterity (assembly) best predicted performance on the pre-practiced tasks. However, for a highly novel, spatially complex laparoscopic task, performance was best predicted by a model that comprised viewingmode, visual-spatialability, and perceivedtaskdemands. At follow-up, manualdexterity (assembly) alone was the best predictor of performance on new (yet similar) tasks.

Conclusion

By focussing exclusively on physical/cognitive abilities, we may overlook other important predictors of surgical performance (e.g. psychological variables). The present findings suggest that laparoscopic performance may be more accurately explained through the combined effects of physical, cognitive, visual, and psychological variables. Further, the results suggest that the predictors may change with both task demands and the development of the trainee. This study highlights the key role of psychological skills in overcoming initial training challenges, with far-reaching implications for practice.

Preventing Irritability and Temper Outbursts in Youth by Building Resilience

Severe irritability and temper outbursts are risk factors for the onset of serious and lifelong mood disorders. In treating children and adolescents with severe irritability, clinicians should evaluate and address safety issues before acute stabilization of symptoms. Then, clinicians can initiate interventions to prevent the onset or relapses of the undesired behavior and its functional consequences. This review summarizes primary, secondary, and tertiary relapse prevention strategies, with an emphasis on strategies that build resilience in youth that mitigate the onset, recurrence, and progression of emotion dysregulation.

Promoting University Students' Mental Health: A Systematic Literature Review Introducing the 4M-Model of Individual-Level Interventions

Objective: The purpose of this study is to systematically review recently published individual student-level interventions aimed at alleviating the burden of mental health challenges faced by the students and/ or at equipping them with coping mechanism that will foster their resilience. Methods: This study relied on a systematic literature review. PubMed dataset was used; the search was confined to the following period: July 2016-December 2020. Results: A total of 1,399 records were identified by the electronic search, out of which 40 studies were included in this study. The authors inductively identified four overlapping categories of interventions across all included articles, and coded them as follows: Mindfulness, Movement, Meaning, and Moderator. Accordingly, each study was linked to at least one of four overlapping categories based on the nature of the intervention(s) under investigation, leading to differing assortments of categories. Conclusions: The 4M-Model generated by this study encourages focusing on devising holistic, university-based interventions that embrace the individuality of students to improve their mental health through elements of mindfulness, movement, meaning, and moderator. Through this focused approach, university counselors are enabled to design interventions that address students' physical, psychological, emotional, and social needs.

Identifying the determinants of emotion regulation choice: a systematic review with meta-analysis

Day-to-day life is inundated with attempts to control emotions and a wealth of research has examined what strategies people use and how effective these strategies are. However, until more recently, research has often neglected more basic questions such as whether and how people choose to regulate their emotions (i.e. emotion regulation choice). In an effort to identify what we know and what we need to know, we systematically reviewed studies that examined potential determinants of whether and how people choose to regulate their emotions. Eighteen determinants were identified across 219 studies and were categorised as being affective, cognitive, motivational, individual or social-cultural in nature. Where there were sufficient primary studies, meta-analysis was used to quantify the size of the associations between potential determinants and measures of whether and how people choose to regulate their emotions. Based on the findings, we propose that people's decisions about whether and how to regulate their emotions are determined by factors relating to the individual doing the regulating, the emotion that is being regulated, and both the immediate situation and the broader social context in which the regulation is taking place.

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

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.