, Volume 8, Issue 3, pp 728–736 | Cite as

The Shape of Change in Perceived Stress, Negative Affect, and Stress Sensitivity During Mindfulness-Based Stress Reduction

  • Evelien Snippe
  • John J. Dziak
  • Stephanie T. Lanza
  • Ivan Nyklíček
  • Marieke Wichers


Both daily stress and the tendency to react to stress with heightened levels of negative affect (i.e., stress sensitivity) are important vulnerability factors for adverse mental health outcomes. Mindfulness-based stress reduction (MBSR) may help to reduce perceived daily stress and stress sensitivity. The purpose of this study was to examine how change in perceived stress, negative affect (NA), and the decoupling between perceived stress and NA evolved over the course of a MBSR program, without making any a priori assumptions on the shape of change. Seventy-one adults from the general population participating in MBSR provided daily diary assessments of perceived stress and NA during MBSR. The time-varying effect model (TVEM) indicated that perceived stress and NA decreased in a linear fashion rather than in a nonlinear fashion, both as a function of time and as a function of the cumulative number of days of mindfulness practice. Both TVEM and multilevel growth modeling showed that the association between perceived stress and NA did not decrease over the course of MBSR. The findings support the hypothesis that MBSR reduces NA and also reduces the extent to which individuals perceive their days as stressful. Also, the results suggest that there is a dose-response relationship between the amount of mindfulness practice and reductions in daily stress and NA.


Daily diary studies Intensive longitudinal methods Stress reactivity Emotional regulation Mindfulness Time-varying effect model 



This project was supported by the Foundation “De Drie Lichten” in the Netherlands, an Aspasia Grant (NWO; to M. Wichers), and Award P50 DA010075 from the National Institute on Drug Abuse. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institute on Drug Abuse or the National Institutes of Health. Data analysis was done using the R 3.2.1 software packages. The R software is copyright 2015 by The R Foundation for Statistical Computing. Finally, we thank Bethany Bray and Runze Li for the very helpful discussions.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures contributing to this work were in accordance with the ethical standards of the relevant national research committees and with the Helsinki declaration of 1964 and its later amendments or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.


  1. Arch, J. J., & Craske, M. G. (2010). Laboratory stressors in clinically anxious and non-anxious individuals: the moderating role of mindfulness. Behaviour Research and Therapy, 48(6), 495–505. doi: 10.1016/j.brat.2010.02.005.PubMedCrossRefGoogle Scholar
  2. Baer, R. A., Carmody, J., & Hunsinger, M. (2012). Weekly change in mindfulness and perceived stress in a mindfulness-based stress reduction program. Journal of Clinical Psychology, 68(7), 755–765. doi: 10.1002/jclp.21865.PubMedCrossRefGoogle Scholar
  3. Baker, F., Denniston, M., Zabora, J., Polland, A., & Dudley, W. N. (2002). A POMS short form for cancer patients: psychometric and structural evaluation. Psycho-Oncology, 11(4), 273–281. doi: 10.1002/pon.564.PubMedCrossRefGoogle Scholar
  4. Bao, X., Xue, S., & Kong, F. (2015). Dispositional mindfulness and perceived stress: the role of emotional intelligence. Personality and Individual Differences, 78, 48–52. doi: 10.1016/j.paid.2015.01.007.CrossRefGoogle Scholar
  5. Barkham, M., Stiles, W. B., & Shapiro, D. A. (1993). The shape of change in psychotherapy: longitudinal assessment of personal problems. Journal of Consulting and Clinical Psychology, 61(4), 667–677. doi: 10.1037/0022-006X.61.4.667.PubMedCrossRefGoogle Scholar
  6. Bolger, N., & Laurenceau, J. (2013). Intensive longitudinal methods: an introduction to diary and experience sampling research. New York, NY US: Guilford Press.Google Scholar
  7. Bolger, N., & Schilling, E. A. (1991). Personality and the problems of everyday life: the role of neuroticism in exposure and reactivity to daily stressors. Journal of Personality, 59(3), 355–386. doi: 10.1111/j.1467-6494.1991.tb00253.x.PubMedCrossRefGoogle Scholar
  8. Britton, W. B., Shahar, B., Szepsenwol, O., & Jacobs, W. J. (2012). Mindfulness-based cognitive therapy improves emotional reactivity to social stress: results from a randomized controlled trial. Behavior Therapy, 43(2), 365–380. doi: 10.1016/j.beth.2011.08.006.PubMedCrossRefGoogle Scholar
  9. Brown, K. W., Weinstein, N., & Creswell, J. D. (2012). Trait mindfulness modulates neuroendocrine and affective responses to social evaluative threat. Psychoneuroendocrinology, 37(12), 2037–2041. doi: 10.1016/j.psyneuen.2012.04.003.PubMedPubMedCentralCrossRefGoogle Scholar
  10. Bullis, J. R., Bøe, H. J., Asnaani, A., & Hofmann, S. G. (2014). The benefits of being mindful: trait mindfulness predicts less stress reactivity to suppression. Journal of Behavior Therapy and Experimental Psychiatry, 45(1), 57–66. doi: 10.1016/j.jbtep.2013.07.006.PubMedCrossRefGoogle Scholar
  11. Chida, Y., & Hamer, M. (2008). Chronic psychosocial factors and acute physiological responses to laboratory-induced stress in healthy populations: a quantitative review of 30 years of investigations. Psychological Bulletin, 134(6), 829–885. doi: 10.1037/a0013342; 10.1037/a0013342.supp (Supplemental).PubMedCrossRefGoogle Scholar
  12. Chu, B. C., Skriner, L. C., & Zandberg, L. J. (2013). Shape of change in cognitive behavioral therapy for youth anxiety: symptom trajectory and predictors of change. Journal of Consulting and Clinical Psychology, 81(4), 573–587. doi: 10.1037/a0033390.PubMedCrossRefGoogle Scholar
  13. Cohen, S., Kamarck, T., & Mermelstein, R. (1983). A global measure of perceived stress. Journal of Health and Social Behavior, 24(4), 385–396. doi: 10.2307/2136404.PubMedCrossRefGoogle Scholar
  14. Creswell, J. D., Pacilio, L. E., Lindsay, E. K., & Brown, K. W. (2014). Brief mindfulness meditation training alters psychological and neuroendocrine responses to social evaluative stress. Psychoneuroendocrinology, 44, 1–12. doi: 10.1016/j.psyneuen.2014.02.007.PubMedCrossRefGoogle Scholar
  15. Davis, M. C., Zautra, A. J., Wolf, L. D., Tennen, H., & Yeung, E. W. (2015). Mindfulness and cognitive–behavioral interventions for chronic pain: differential effects on daily pain reactivity and stress reactivity. Journal of Consulting and Clinical Psychology, 83(1), 24–35. doi: 10.1037/a0038200.PubMedCrossRefGoogle Scholar
  16. Dziak, J. J., Li, R., Tan, X., Shiffman, S., & Shiyko, M. P. (2015). Modeling intensive longitudinal data with mixtures of nonparametric trajectories and time-varying effects. Psychological Methods, 20(4), 444–469. doi: 10.1037/met0000048.PubMedPubMedCentralCrossRefGoogle Scholar
  17. Eilers, P., & Marx, B. (1996). Flexible smoothing with B-splines and penalties. Statistical Science, 11(2), 89–102. doi: 10.1214/ss/1038425655.CrossRefGoogle Scholar
  18. Feldman, G., Lavallee, J., Gildawie, K., & Greeson, J. M. (2016). Dispositional mindfulness uncouples physiological and emotional reactivity to a laboratory stressor and emotional reactivity to executive functioning lapses in daily life. Mindfulness, 7(2), 527–541. doi: 10.1007/s12671-015-0487-3.PubMedPubMedCentralCrossRefGoogle Scholar
  19. Gunthert, K. C., Cohen, L. H., Butler, A. C., & Beck, J. S. (2007). Depression and next-day spillover of negative mood and depressive cognitions following interpersonal stress. Cognitive Therapy and Research, 31(4), 521–532. doi: 10.1007/s10608-006-9074-1.CrossRefGoogle Scholar
  20. Hammen, C. (2015). Stress sensitivity in psychopathology: mechanisms and consequences. Journal of Abnormal Psychology, 124(1), 152–154. doi: 10.1037/abn0000040.PubMedCrossRefGoogle Scholar
  21. Hastie, T., & Tibshirani, R. (1993). Varying-coefficient models. Journal of the Royal Statistical Society Series B-Methodological, 55(4), 757–796.Google Scholar
  22. Hayes, A. M., Laurenceau, J. P., Feldman, G., Strauss, J. L., & Cardaciotto, L. (2007). Change is not always linear: the study of nonlinear and discontinuous patterns of change in psychotherapy. Clinical Psychology Review, 27(6), 715–723.PubMedPubMedCentralCrossRefGoogle Scholar
  23. Hoge, E. A., Bui, E., Marques, L., Metcalf, C. A., Morris, L. K., Robinaugh, D. J., & Simon, N. M. (2013). Randomized controlled trial of mindfulness meditation for generalized anxiety disorder: effects on anxiety and stress reactivity. Journal of Clinical Psychiatry, 74(8), 786–792.PubMedPubMedCentralCrossRefGoogle Scholar
  24. Hoorelbeke, K., Koster, E. H. W., Vanderhasselt, M., Callewaert, S., & Demeyer, I. (2015). The influence of cognitive control training on stress reactivity and rumination in response to a lab stressor and naturalistic stress. Behaviour Research and Therapy, 69, 1–10. doi: 10.1016/j.brat.2015.03.010.PubMedCrossRefGoogle Scholar
  25. Ietsugu, T., Crane, C., Hackmann, A., Brennan, K., Gross, M., Crane, R. S., & Barnhofer, T. (2014). Gradually getting better: trajectories of change in rumination and anxious worry in mindfulness-based cognitive therapy for prevention of relapse to recurrent depression. Mindfulness. doi: 10.1007/s12671-014-0358-3.Google Scholar
  26. Kabat-Zinn, J. (1990). Full catastrophe living: using the wisdom of your body and mind to face stress, pain, and illness. New York, US: Delacourt.Google Scholar
  27. Kabat-Zinn, J. (1994). Wherever you go, there you are: mindfulness meditation in everyday life. New York: Hyperion.Google Scholar
  28. Kok, G., van Rijsbergen, G., Burger, H., Elgersma, H., Riper, H., Cuijpers, P., Bockting, C. (2014). The scars of childhood adversity: minor stress sensitivity and depressive symptoms in remitted recurrently depressed adult patients. PLoS ONE, 9(11)Google Scholar
  29. Levin, M. E., Luoma, J. B., & Haeger, J. A. (2015). Decoupling as a mechanism of change in mindfulness and acceptance: a literature review. Behavior Modification, 39(6), 870–911. doi: 10.1177/0145445515603707.PubMedCrossRefGoogle Scholar
  30. Luyten, P., Kempke, S., Van Wambeke, P., Claes, S., Blatt, S. J., & Van Houdenhove, B. (2011). Self-critical perfectionism, stress generation, and stress sensitivity in patients with chronic fatigue syndrome: relationship with severity of depression. Psychiatry: Interpersonal and Biological Processes, 74(1), 21–30. doi: 10.1521/psyc.2011.74.1.21.CrossRefGoogle Scholar
  31. Myin-Germeys, I., Peeters, F., Havermans, R., Nicolson, N. A., deVries, M. W., Delespaul, P., & van Os, J. (2003). Emotional reactivity to daily life stress in psychosis and affective disorder: an experience sampling study. Acta Psychiatrica Scandinavica, 107(2), 124–131. doi: 10.1034/j.1600-0447.2003.02025.x.PubMedCrossRefGoogle Scholar
  32. Nyklíček, I., Mommersteeg, P. M. C., Van Beugen, S., Ramakers, C., & Van Boxtel, G. J. (2013). Mindfulness-based stress reduction and physiological activity during acute stress: a randomized controlled trial. Health Psychology, 32(10), 1110–1113. doi: 10.1037/a0032200; 10.1037/a0032200.supp.PubMedCrossRefGoogle Scholar
  33. Roberts, J. E., & Kassel, J. D. (1997). Labile self-esteem, life stress, and depressive symptoms: prospective data testing a model of vulnerability. Cognitive Therapy and Research, 21(5), 569–589. doi: 10.1023/A:1021861503072.CrossRefGoogle Scholar
  34. Schiepek, G. K., Tominschek, I., & Heinzel, S. (2014). Self-organization in psychotherapy: testing the synergetic model of change processes. Frontiers in Psychology, 5, 1089. doi: 10.3389/fpsyg.2014.01089.PubMedPubMedCentralCrossRefGoogle Scholar
  35. Shacham, S. (1983). A shortened version of the profile of mood states. Journal of Personality Assessment, 47(3), 305–306. doi: 10.1207/s15327752jpa4703_14.PubMedCrossRefGoogle Scholar
  36. Shiyko, M. P., Burkhalter, J., Li, R., & Park, B. J. (2014). Modeling nonlinear time-dependent treatment effects: an application of the generalized time-varying effect model (TVEM). Journal of Consulting and Clinical Psychology, 82(5), 760–772. doi: 10.1037/a0035267.PubMedCrossRefGoogle Scholar
  37. Snippe, E., Nyklíček, I., Schroevers, M. J., & Bos, E. H. (2015). The temporal order of change in daily mindfulness and affect during mindfulness-based stress reduction. Journal of Counseling Psychology, 62(2), 106–114. doi: 10.1037/cou0000057.PubMedCrossRefGoogle Scholar
  38. Tan, X., Shiyko, M. P., Li, R., Li, Y., & Dierker, L. (2012). A time-varying effect model for intensive longitudinal data. Psychological Methods, 17(1), 61–77. doi: 10.1037/a0025814; 10.1037/a0025814.supp.PubMedCrossRefGoogle Scholar
  39. van Son, J., Nyklíček, I., Pop, V. J., Blonk, M. C., Erdtsieck, R. J., Spooren, P. F., & Pouwer, F. (2013). The effects of a mindfulness-based intervention on emotional distress, quality of life, and HbA(1c) in outpatients with diabetes (DiaMind). Diabetes Care, 36(4), 823–830. doi: 10.2337/dc12-1477.PubMedPubMedCentralCrossRefGoogle Scholar
  40. van Winkel, M., Nicolson, N. A., Wichers, M., Viechtbauer, W., Myin-Germeys, I., & Peeters, F. (2015). Daily life stress reactivity in remitted versus non-remitted depressed individuals. European Psychiatry, 30(4), 441–447. doi: 10.1016/j.eurpsy.2015.02.011.PubMedCrossRefGoogle Scholar
  41. Vittengl, J. R., Clark, L. A., Thase, M. E., & Jarrett, R. B. (2013). Nomothetic and idiographic symptom change trajectories in acute-phase cognitive therapy for recurrent depression. Journal of Consulting and Clinical Psychology, 81(4), 615–626. doi: 10.1037/a0032879.PubMedCrossRefGoogle Scholar
  42. von Haaren, B., Loeffler, S. N., Haertel, S., Anastasopoulou, P., Stumpp, J., Hey, S., & Boes, K. (2013). Characteristics of the activity-affect association in inactive people: an ambulatory assessment study in daily life. Frontiers in Psychology, 4 doi: 10.3389/fpsyg.2013.00163
  43. Wald, F. D., & Mellenbergh, G. J. (1990). De verkorte versie van de nederlandse vertaling van de profile of mood states (POMS). Nederlands Tijdschrift Voor De Psychologie En Haar Grensgebieden, 45(2), 86–90.Google Scholar
  44. Weinstein, N., Brown, K. W., & Ryan, R. M. (2009). A multi-method examination of the effects of mindfulness on stress attribution, coping, and emotional well-being. Journal of Research in Personality, 43(3), 374–385. doi: 10.1016/j.jrp.2008.12.008.CrossRefGoogle Scholar
  45. Wichers, M., Peeters, F., Geschwind, N., Jacobs, N., Simons, C. J. P., Derom, C., & van Os, J. (2010). Unveiling patterns of affective responses in daily life may improve outcome prediction in depression: a momentary assessment study. Journal of Affective Disorders, 124(1–2), 191–195.PubMedCrossRefGoogle Scholar
  46. Wichers, M., Geschwind, N., Jacobs, N., Kenis, G., Peeters, F., Derom, C., & van Os, J. (2009). Transition from stress sensitivity to a depressive state: longitudinal twin study. The British Journal of Psychiatry, 195(6), 498–503. doi: 10.1192/bjp.bp.108.056853.PubMedCrossRefGoogle Scholar
  47. Wichers, M., Myin-Germeys, I., Jacobs, N., Peeters, F., Kenis, G., Derom, C., & van Os, J. (2007). Genetic risk of depression and stress-induced negative affect in daily life. The British Journal of Psychiatry, 191(3), 218–223. doi: 10.1192/bjp.bp.106.032201.PubMedCrossRefGoogle Scholar
  48. Wright, A. G. C., Hallquist, M. N., Swartz, H. A., Frank, E., & Cyranowski, J. M. (2014). Treating co-occurring depression and anxiety: modeling the dynamics of psychopathology and psychotherapy using the time-varying effect model. Journal of Consulting and Clinical Psychology, 82(5), 839–853. doi: 10.1037/a0034430.PubMedCrossRefGoogle Scholar
  49. Zainal, N. Z., Booth, S., & Huppert, F. A. (2013). The efficacy of mindfulness-based stress reduction on mental health of breast cancer patients: a meta-analysis. Psycho-Oncology, 22(7), 1457–1465. doi: 10.1002/pon.3171.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Evelien Snippe
    • 1
    • 2
  • John J. Dziak
    • 3
  • Stephanie T. Lanza
    • 3
    • 4
  • Ivan Nyklíček
    • 5
  • Marieke Wichers
    • 1
  1. 1.University of Groningen, University Medical Center Groningen, Interdisciplinary Center Psychopathology and Emotion regulationGroningenthe Netherlands
  2. 2.Department of Psychiatry & Neuropsychology, School for Mental Health and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
  3. 3.The Methodology CenterThe Pennsylvania State UniversityState CollegeUSA
  4. 4.Department of Biobehavioral HealthThe Pennsylvania State UniversityState CollegeUSA
  5. 5.Center of Research on Psychology in Somatic diseases (CoRPS), Department of Medical and Clinical PsychologyTilburg UniversityTilburgthe Netherlands

Personalised recommendations