Responding to Uncertain Threat: A Potential Mediator for the Effect of Mindfulness on Anxiety

Abstract Mindfulness-based interventions have gained extensive support for their application in the treatment of anxiety. However, their mechanisms remain largely unexplored. Excessive reactivity to uncertainty plays a central role in anxiety, and may represent a mechanism for the effect of mindfulness on anxiety, as mindfulness training fosters an open and accepting stance towards all aspects of experience. The present study sought to investigate both (i) self-reported intolerance of uncertainty (IU) as well as (ii) physiological and subjective responding to uncertain threat in a threat-of-shock paradigm, the NPU-threat test, as mediators for the relationship between mindfulness and anxiety in a cross-sectional study of healthy participants (N = 53). The results indicated that IU mediated the effect of mindfulness on some anxiety symptoms. In contrast, scores of physiological as well as subjective responses to uncertain threat from the NPU-threat test were largely unrelated to mindfulness, anxiety, or the IU self-report measure. The results provide initial evidence that reactions to uncertainty may play a role in the mindfulness-anxiety relationship and suggest that studies are needed to address how methodological variations of the NPU-threat test affect perceived levels of uncertainty and uncertainty-related anxiety.