Examining the Role of Mindfulness and Emotion Regulation Strategy Use in Emotion Dysregulation in Multiple Sclerosis

Background: Dispositional mindfulness is defined as the ability to attend to present-moment experiences with receptive awareness. Greater dispositional mindfulness has been linked to higher quality of life, reduced psychological distress, and lower levels of emotion dysregulation in individuals with MS. It has been suggested that dispositional mindfulness may deliver its prophylactic effects through enhanced emotion regulation. Research examining dispositional mindfulness in non-MS populations suggests that individuals high in mindfulness exhibit more frequent use of adaptive emotion regulation strategies, such as cognitive reappraisal, and less frequent use of maladaptive strategies, including thought avoidance, worry, and rumination.

Objectives: Given the high prevalence of emotion dysregulation in individuals with MS and the potential ameliorative capacity of mindfulness, we sought to examine associations between dispositional mindfulness, emotion regulation strategy use, and emotion dysregulation in this population.

Methods: We administered the contextual emotion regulation survey to a sample of individuals with MS. Participants were asked to generate twenty-four emotion-eliciting situations they encountered in the preceding two weeks, across two environments (health, social), three intensities (low, medium, high), and four emotions (anxiety, anger, sadness, happiness). Eight of these situations were presented back to the participants, who were then asked to rate the extent to which they utilized cognitive reappraisal, thought avoidance, and worry/rumination to regulate their emotions.

Results: While no associations were seen between dispositional mindfulness and use of cognitive reappraisal, greater dispositional mindfulness was associated with less frequent use of thought avoidance and worry/rumination. Less frequent use of thought avoidance and worry/rumination was associated with lower levels of emotion dysregulation. Employing a multiple mediation model, we found that use of worry/rumination partially mediated the relationship between dispositional mindfulness and emotion dysregulation, such that individuals who are high in dispositional mindfulness exhibit less frequent use of worry/rumination and in turn perceive lower levels of emotion dysregulation.

Conclusions: The results of this cross-sectional study suggest that reduced worry/rumination may act as a pathway through which mindfulness achieves its prophylactic effects on emotional health in MS.