Who Benefits Most from a Brief Mindfulness Intervention to Reduce Anxiety During Stereotactic Breast Biopsy: the Moderating Effect of Trait Mindfulness, Spiritual Well-being, and Distress Tolerance

Objectives This study examined trait mindfulness, spiritual well-being, and distress tolerance as moderators of the effect of a brief mindfulness intervention on anxiety reported during stereotactic breast biopsy (SBB). Methods This is a secondary analysis of an RCT examining guided meditation (GM; n = 30), focused breathing (FB; n = 30), or standard care (SC; n = 16) on anxiety for women undergoing SBB. Women in GM and FB were guided through their respective interventions for 10 min before and during biopsy. Anxiety (0–10 visual analogue scale), trait mindfulness (FFMQ), spiritual well-being (FACIT-SP), and discomfort intolerance (DI) were assessed at baseline, and anxiety was assessed every 4 min during SBB. Multilevel modeling examined moderator-by-group-by-time interactions. Significant 3-way interactions were decomposed using a median split. Results FFMQ observing, FFMQ describing, FACIT-SP meaning/peace, and DI moderated the group-by-time effects on anxiety during biopsy ( p ’s < 0.03). For those high in FFMQ describing, FACIT-SP-Meaning/Peace, or DI, GM was associated with a steeper reduction in anxiety compared to FB and SC ( p ’s < 0.05). For those low in FFMQ describing, FFMQ observing, and FACIT-SP-Meaning/Peace, both GM and FB were associated with a steeper reduction in anxiety compared to SC ( p’s < 0.05). Conclusions Individuals high in mindful describing, high in the meaning/peace aspect of spiritual well-being, and high in distress intolerance may benefit most from GM. Individuals low in attentional aspects of mindfulness (i.e., describing and observing) and low in the meaning/peace aspect of spiritual well-being may benefit from either a GM or FB intervention. Trial Registration ClinicalTrial.org (NCT03023215)