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Who Benefits Most from a Brief Mindfulness Intervention to Reduce Anxiety During Stereotactic Breast Biopsy: the Moderating Effect of Trait Mindfulness, Spiritual Well-being, and Distress Tolerance

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Abstract

Objectives

This study examined trait mindfulness, spiritual well-being, and distress tolerance as moderators of the effect of a brief mindfulness intervention on anxiety reported during stereotactic breast biopsy (SBB).

Methods

This is a secondary analysis of an RCT examining guided meditation (GM; n = 30), focused breathing (FB; n = 30), or standard care (SC; n = 16) on anxiety for women undergoing SBB. Women in GM and FB were guided through their respective interventions for 10 min before and during biopsy. Anxiety (0–10 visual analogue scale), trait mindfulness (FFMQ), spiritual well-being (FACIT-SP), and discomfort intolerance (DI) were assessed at baseline, and anxiety was assessed every 4 min during SBB. Multilevel modeling examined moderator-by-group-by-time interactions. Significant 3-way interactions were decomposed using a median split.

Results

FFMQ observing, FFMQ describing, FACIT-SP meaning/peace, and DI moderated the group-by-time effects on anxiety during biopsy (p’s < 0.03). For those high in FFMQ describing, FACIT-SP-Meaning/Peace, or DI, GM was associated with a steeper reduction in anxiety compared to FB and SC (p’s < 0.05). For those low in FFMQ describing, FFMQ observing, and FACIT-SP-Meaning/Peace, both GM and FB were associated with a steeper reduction in anxiety compared to SC (p’s < 0.05).

Conclusions

Individuals high in mindful describing, high in the meaning/peace aspect of spiritual well-being, and high in distress intolerance may benefit most from GM. Individuals low in attentional aspects of mindfulness (i.e., describing and observing) and low in the meaning/peace aspect of spiritual well-being may benefit from either a GM or FB intervention.

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(NCT03023215)

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Funding

This work was supported by a National Cancer Institute cancer prevention fellowship for Chelsea G. Ratcliff (Grant Number R25T CA057730, PI: Shine Chang) and the National Cancer Institute Cancer Center Support (Grant Number A016672).

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Authors and Affiliations

  1. Department of Psychology and Philosophy, Sam Houston State University, 1901 Avenue I, Suite 390, Huntsville, TX, 77341, USA

    Chelsea G. Ratcliff, Shaelyn N. Fowler & Kelsey L. Sinclair

  2. Baylor College of Medicine, One Baylor Plaza, Houston, TX, USA

    Chelsea G. Ratcliff

  3. Department of Breast Imaging, The University of Texas M. D. Anderson Cancer Center, 1515 Holcombe Blvd, Unit 1350, Houston, TX, 77030, USA

    Sarah Prinsloo, Alejandro Chaoul, Amy Spelman, Wei T. Yang & Lorenzo Cohen

  4. Our Lady of the Lake University, The Woodlands, TX, USA

    Stephanie G. Zepeda

Authors
  1. Chelsea G. Ratcliff
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  2. Shaelyn N. Fowler
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  3. Kelsey L. Sinclair
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  4. Sarah Prinsloo
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  5. Alejandro Chaoul
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  7. Amy Spelman
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  8. Wei T. Yang
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  9. Lorenzo Cohen
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Contributions

CGR designed and executed the study, conducted the data analyses, and wrote the paper. SF assisted in writing the manuscript. KS assisted in writing the manuscript. SP collaborated with the design of the study. AC collaborated with the design of the study. SGZ collaborated with the design of the study and assisted in executing the study. AS collaborated with the design of the study. WY collaborated with the design of the study. LC collaborated in the design of the study and writing and editing of the final manuscript.

Corresponding author

Correspondence to Chelsea G. Ratcliff.

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The authors declare that they have no conflicts of interest.

Ethics Statement

This protocol was approved by the University of Texas MD Anderson Cancer Center Institutional Review Board.

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All participants gave their informed consent prior to inclusion in the study.

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Ratcliff, C.G., Fowler, S.N., Sinclair, K.L. et al. Who Benefits Most from a Brief Mindfulness Intervention to Reduce Anxiety During Stereotactic Breast Biopsy: the Moderating Effect of Trait Mindfulness, Spiritual Well-being, and Distress Tolerance. Mindfulness 12, 1127–1137 (2021). https://doi.org/10.1007/s12671-020-01581-6

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