Reconceptualizing the relationship between anxiety, mindfulness, and cognitive control

Abstract

Prior research has provided initial support for the claim that cognitive control mediates the relationship between anxiety and mindfulness; however, findings are often inconsistent. In this review, we argue that the inconsistency may be due to a lack of both conceptual and methodological precision in terms of how anxiety, cognitive control, and mindfulness are operationalized and assessed, and that this imprecision may be a critical source of study confounds and ambiguous outcomes. We unpack this argument by first decomposing anxiety, cognitive control, mindfulness, and relevant experimental paradigms into key dimensions in order to develop a non-unitary, multi-dimensional taxonomy of these constructs. Subsequently, we review and reinterpret the prior experimental literature, focusing on studies that examine the relationship between anxiety and cognitive control, mindfulness and cognitive control, and the three-way relationship between anxiety, mindfulness, and cognitive control. Across the reviewed studies, there was great variation in the dimensions being examined and the behavioral and/or neural measures employed; therefore, results were often mixed. Based on this review of literature, we propose a conceptually and methodologically precise framework from which to study the effects of mindfulness on cognitive control in anxiety. The framework theoretically aligns anxiety dimensions with specific mindfulness states and interventions, further suggesting how these will impact specific cognitive control dimensions (proactive, reactive). These can be assessed with experimental paradigms and associated behavioral and neural metrics to index the relevant dimensions with high precision. Novel experimental studies and tractable research designs are also proposed to rigorously test this theoretical framework.