title: Mediators of Mindfulness-Based Stress Reduction (MBSR): assessing the timing and sequence of change in cancer patients.
abstract: OBJECTIVE
  This waitlist-controlled study examined the timing of changes during Mindfulness-Based Cancer Recovery (MBCR), and explored sequential mediated effects through enhanced mindfulness and emotion regulation (ER) in a cancer population.
  
  
  METHODS
  Patients were recruited from the MBCR program waitlist and were either registered for immediate participation (n = 135) or waiting for the next program to begin (n = 76). Participants completed self-report measures of stress symptoms, mood disturbance, mindfulness, and ER (rumination, worry, and experiential avoidance) pre-, mid- and post-MBCR or waiting period.
  
  
  RESULTS
  There was a relatively early effect of MBCR on observing, nonjudging, rumination, and worry. All other measures changed later. Early changes in present-focused nonjudgmental awareness, rumination, and worry mediated the effect of MBCR on mindfulness skills such as nonreactivity later on.
  
  
  CONCLUSIONS
  The constructs of mindfulness and ER may overlap and changes may be mutually facilitative during MBCR. The study informs our understanding of mindfulness and ER as mechanisms of mindfulness-based interventions.
authors.affiliation: University of Calgary, Department of Oncology and Alberta Health Services.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Labelle
authors.forename: Tavis S
authors.initials: TS
authors.lastname: Campbell
authors.forename: Peter
authors.initials: P
authors.lastname: Faris
authors.forename: Linda E
authors.initials: LE
authors.lastname: Carlson
mesh_terms: D000328:Adult; D000368:Aged; D002173:Cancer Care Facilities; D004644:Emotions; D005260:Female; D006801:Humans; D016014:Linear Models; D008137:Longitudinal Studies; D008297:Male; D019122:Meditation / Q000379:methods / Q000523:psychology; D008875:Middle Aged; D064866:Mindfulness / Q000379:methods*; D009369:Neoplasms / Q000523:psychology*; D057566:Self Report; D013315:Stress, Psychological / Q000628:therapy*; D016896:Treatment Outcome; D014850:Waiting Lists
keywords: cancer; mindfulness; meditation; emotion regulation; mechanisms