Re-routing Pathways to Depression: Effects of Mindfulness on Internalized Stigma, Appraisals, Coping and Depressive Symptoms

Despite increasing research and accessibility of treatment, depression remains a leading cause of global disease and disability, and depression rates among young adults continue to rise (WHO, 2007). Both trait mindfulness and mindfulness training have been inversely associated with depressive symptoms (e.g., Segal, Williams & Teasdale, 2002), however, the processes underlying this effect are not fully understood. The goal of the present program of research was to identify the extent to which psychosocial variables (including internalized stigma, coping, appraisal and stressor responses) account for the relationship between mindfulness and well-being. In Study 1 (N = 368), trait mindfulness predicted lower endorsement of internalized stigma and greater endorsement of positive appraisals and adaptive coping repertoires among young adults, which in turn predicted a decrease in depressive symptoms. In Study 2, an analysis of both student (N = 372) and community (N = 275) samples revealed that trait mindfulness inversely predicted the use of emotion-focused coping techniques in response to a variety of interpersonal, financial, and workplace/academic stressors, while mindful coping was associated with greater perceptions of controllability and the use of problem-focused coping strategies. Study 3 sought to determine if trait mindfulness (Study 3.1; N = 19) and brief mindfulness training (Study 3.2; N = 87) influenced psychological response (e.g., anxiety, affect), coping, and neuroendocrine response following an acute stressor task. Facets of mindful observing and awareness predicted lower baseline cortisol among participants, while non-reacting to experience predicted a diminished cortisol response from baseline to post-stressor task. No differences in coping, psychological or neuroendocrine response were observed as a function of a brief mindfulness intervention, suggesting that longer interventions may be needed to elicit beneficial effects. These results support an inverse relationship between trait mindfulness and negative appraisals, internalized stigma, and the use of emotion-focused coping strategies, and suggest that these variables might constitute important pathways in the relationship between trait mindfulness and depressive symptoms. Programs targeted at developing mindfulness skills might be particularly effective in mitigating physical and psychological responses to stressors among individuals at risk of depressive illness.