Indices of association between anxiety and mindfulness: a guide for future mindfulness studies

Mindfulness and anxiety are often linked as inversely related traits and there have been several theoretical and mediational models proposed suggesting such a relationship between these two traits. The current review report offers an account of self-report measures, behavioral, electrophysiological, hemodynamic, and biological studies, which provide converging evidence for an inverse relationship between mindfulness and anxiety. To our knowledge, there are no comprehensive accounts of empirical evidence that investigate this relationship. After reviewing several empirical studies, we propose a schematic model, where a stressor can trigger the activation of amygdala which activates the hypothalamic-pituitary-adrenal (HPA) pathway. This hyperactive HPA axis leads to a cascade of psychological, behavioral, electrophysiological, immunological, endocrine, and genetic reactions in the body, primarily mediated by a sympathetic pathway. Conversely, mindfulness protects from deleterious effects of these triggered reactions by downregulating the HPA axis activity via a parasympathetic pathway. Finally, we propose a model suggesting a comprehensive scheme through which mindfulness and anxiety may interact through emotion regulation. It is recommended that future mindfulness intervention studies should examine a broad spectrum of measurement indices where possible, keeping logistic feasibility in mind and look at mindfulness in conjunction with anxiety rather than independently.