Bernstein
Bernstein
Bernstein
Amit Bernsteina
Yuval Hadasha
David M. Frescob
a
University of Haifa
b
Kent State University
Mindfulness
Author Note
(facsimile).
Running Head: DECENTERING METHODS AND INSIGHTS 2
Abstract
processes and the novel insights they provide regarding the nature and salutary function(s) of
processes. Findings support the theorized inter-relations of the metacognitive processes, help
to elucidate the pathways through which they may contribute to mental health, and provide
interventions.
Highlights
Introduction
Decentering reflects the capacity to shift experiential perspective – from within one’s
1979; Hayes, Strosahl, & Wilson, 2012; *Teasdale et al., 2002; Wells, 2000). Decentering
has been a particular focus of mindfulness mechanisms research for over two decades due to
its explicit therapeutic role in Mindfulness Based Cognitive Therapy (Segal, Williams, &
Teasdale, 2018) as well as its theorized salutary and curative role as a mediating mechanism
of action across a variety of MBIs (*Bernstein et al., 2015; Brown, Ryan, & Creswell, 2007;
Creswell, 2017; *Dahl, Lutz, & Davidson, 2015; Shapiro et al., 2006; Vago & Silbersweig,
2012).
In the hopes of better understanding and advancing the study of this phenomenon, we
together constitute the mental phenomenon commonly referred to as decentering (see Figure
*Dahl, Lutz & Davidson, 2015; *Smallwood & Schooler, 2015). It is distinguished from
awareness of the contents of thoughts (i.e., metal representations) without concurrent meta-
experience of internal states as separate from one’s self. Reduced reactivity to thought
content refers to the reduced effects of thought content on other mental processes (e.g.,
Disidentification
from Internal
Experience
The experience of
internal states as
Meta- separate from one’s self
Awareness
Awareness of
subjective experience Reduced
Reactivity to
Thought
Content
Reduced effects of
thought content on
other mental processes
to thought content, which in turn affect one another, and feedback to reinforce meta-
constructs through the prism of the proposed metacognitive processes model (see Table 1).
Of particular relevance here, Bernstein et al concluded that extant decentering science was
could significantly contribute to advancing our understanding of the nature and function of
the phenomenon, its role in mental health and as a mechanism of action in MBIs; and in turn,
our capacity to more optimally therapeutically target the phenomenon to promote mental
in the science of decentering and related constructs and, in turn, the substantive insights that
they are beginning to provide with respect to decentering, mental health and mindfulness
decentering and related constructs, (II) intensive experience sampling study of the
Metacognitive Processes
Decentering-Related Disidentification Reduced
Constructs Meta-Awareness from Internal Reactivity to
Experience Thought Content
Decentering (Safran &
x x x
Segal, 1990)
Metacognitive Awareness
x x x
(*Teasdale et al., 2002)
Cognitive Distancing
x x x
(Beck et al., 1979)
Metacognitive Mode
x x x
(Wells, 2000)
Detached Mindfulness
x x x
(Wells, 2005)
Running Head: DECENTERING METHODS AND INSIGHTS 6
Reperceiving (Shapiro et
x x
al., 2006)
Mindfulness (Bishop et al.,
x
2004)
Cognitive Defusion
x
(Hayes et al., 2012)
Self-as-Context (Hayes et
x
al., 2012)
Self-Distanced Perspective
x
(Kross et al., 2005)
Dereification (Lutz, Jha et
x
al., 2015)
Note. An X denotes the metacognitive process(es) proposed to subserve various decenter-
validity and latent dimensional structure of extant self-report scales of decentering and
related constructs (*Hadash, Lichtash, & Bernstein, 2017; *Naragon-Gainey & DeMarree,
2017). Despite methodological differences, both studies reported a two-factor solution that
was conceptually and empirically similar. One factor reflecting disidentified and non-reactive
second factor reflecting reduced reactivity to thought content – labeled “Automatic Reactivity
to Thought Content” (Hadash et al., 2017) and “Reduced Struggle with Inner Experience”
report scales assesses all three proposed metacognitive processes comprehensively. Indeed,
Running Head: DECENTERING METHODS AND INSIGHTS 7
measures to-date were not grounded theoretically in this model or metacognitive processes
perspective on the phenomenon. Second, extant self-report scales of decentering and related
constructs are not interchangeable and differ in their psychometric performance and the
process(es) they measure. Third, several measures demonstrated low internal consistencies,
and a large number of items from studied measures did not load on observed factors.
items reflecting self-compassion or acceptance, were empirically excluded from the final
factor solutions. Accordingly, further self-report scale development is needed and may be
Experience sampling (ES) methods help to address key limitations of traditional self-
report assessment of subjective experience (e.g., retrospective recall bias). ES methods entail
repeated sampling of subjects’ current behaviors, experiences, and contexts in real time, in
subjects’ real-world environment, providing measurement data with high temporal and
contextual resolution (Dimotakis & Ilies, 2012; Shiffman, Stone, & Hufford, 2008).
disidentification from internal experience, reduced reactivity to thought content, among other
processes, over the course of a MBI (*Shoham et al, 2017). Findings indicate that in daily
living and meditative states, participants displayed cumulative elevation in all three
metacognitive processes over the course of the intervention. Moreover, as predicted by the
metacognitive processes model, the greater the degree to which participants were meta-aware
of their experience, the more disidentified they were from that experience and the less
reactive they were to their thought content. Although these effects were observed in daily
living, they were significantly stronger in experience samples during mindfulness meditation
practice. Importantly, in line with the metacognitive processes model, greater levels of meta-
Running Head: DECENTERING METHODS AND INSIGHTS 8
awareness were related to greater positive emotional valence and reduced emotional arousal
(Shoham et al, 2017). Moreover, to study reactivity to negative thought content, Shoham,
Hadash, and Bernstein (2018) used ES to present participants with their own distressing
personal negative self-referential thought content (e.g., “I’m a failure”; individual thought
associated with reduced reactivity to negative self-referential thought content, in the form of
the degree of distress elicited by the thoughts remained elevated and unchanged over the
Meta-Awareness
see Hadash and Bernstein (in press) in this issue. Here, we focus on findings from studies
utilizing three behavioral methods that are particularly relevant for the metacognitive
processes model of decentering. One method entails probe- and self-caught real time ES
during performance of cognitive tasks (e.g., go/no-go task) as well as during mindfulness
Schooler et al., 2011; *Smallwood & Schooler, 2015). Interestingly, mind wandering with
and without meta-awareness, measured using these methods, are differentiated processes with
distinct neural (Christoff, Gordon, Smallwood, Smith, & Schooler, 2009; Hasenkamp,
Wilson-Mendenhall, Duncan, & Barsalou, 2012; Smith et al., 2006) and cognitive correlates
(*Smallwood & Schooler, 2015). Moreover, findings indicate that meta-awareness of mind
wandering may reduce the occurrence of mind wandering (*Smallwood & Schooler, 2015),
Running Head: DECENTERING METHODS AND INSIGHTS 9
and meta-awareness during mind wandering may buffer detrimental effects of mind
construct mental models; Smallwood, McSpadden, & Schooler, 2007). Of relevance to the
metacognitive processes model of decentering, the latter effects and set of findings may
reflect the theorized effects of meta-awareness on reduced reactivity to thought content (i.e.,
A second approach to measure meta-awareness applies the first and third person
correspondence method (Hadash & Bernstein, in press, this issue). This approach entails
comparison of subjective (i.e., first-person) reports of internal experience with objective (i.e.,
that experience. This method is used to measure accurate meta-awareness of subtle changes
Garfinkel et al., 2015; Kleckner & Quigley, 2015). Based on this methodology, *Ruimi et al
(2018) developed the Probe-Caught Meta-Awareness of Bias task, to quantify accurate meta-
time subjective reports of biased attention (i.e., first person reports), concurrent with the
objective trial-level expressions of biased attention in a probe detection or similar task (i.e.,
subjective ES reports of biased attention with objective performance data. Ruimi et al (2018)
biased attention with accurate meta-awareness were more likely followed by more balanced
processes model, findings suggest that accurate meta-awareness effects attentional regulation,
mindfulness meditation (see Hadash & Bernstein, in press, this issue for details). In the MAT
experience they notice (e.g., “hearing”, “thinking”) and by pressing a button when they notice
manualized qualitative coding of the content of participant’s verbal labels. In addition, the
precise timing and order of all reports of mindful awareness (i.e., labels and button presses)
are analyzed to compute indices related to the time-course of meta-awareness (e.g., latency of
associated with mental health outcomes (e.g., meta-awareness of mental experience predicted
wandering predicted higher levels of self-regulation and lower levels of depression symptoms
2018).
Plonsker, Vago and Bernstein (2016) developed the Single Experience & Self-Implicit
experience (e.g., using videos and audio) and the concurrent measurement of participant’s
cognitive association between self and the elicited subjective experience by means of an
Implicit Association Test. Hadash et al (2016) tested one variant of this paradigm to measure
individual differences in identification with and negative judgments of fear. Consistent with
the metacognitive processes model of decentering, they found that lower levels of (implicit)
identification with fear were associated with greater levels of self-reported meta-awareness of
To measure reactivity to one’s own thought content, Amir, Ruimi and Bernstein (I
developed the Simulated Thoughts Paradigm. To do so, the Simulated Thoughts Paradigm
presents idiographic negative or neutral self-referential thought content via audio stimuli, in
the participant’s own (recorded) voice, to experimentally elicit an experience that feels like
thinking one’s thoughts. This paradigm was implemented during an external (visual) Digit
Categorization Task (odd vs. even; Sudevan & Taylor, 1987). The task required participants
to, repeatedly, disengage internal attention from a simulated thought so as to allocate that
attention externally to the digit categorization task and stimulus. Amir et al found that
external task and stimulus; this difficulty disengaging attention predicted degree of negative
repetitive thinking and related measures of cognitive vulnerability; which, in turn, predicted
degree of depression and anxiety symptom levels. These findings are consistent with the
reactivity to thought content in mental health problems, and helps specify pathways through
the metacognitive processes help test causal relations between the processes and between the
processes and mental health. Such methods may also ultimately demonstrate therapeutic
behavior driven by biased attention (Bernstein & Zvielli, 2014). Randomized controlled
experimental studies found that, among anxious adults, real-time feedback was associated
information as well as reduced emotional reactivity to, and facilitated recovery following, an
anxiogenic stressor (Bernstein & Zvielli, 2014; *Zvielli, Amir, Goldstein, & Bernstein,
2015). More recently, Ruimi, Hendren, Amir, Zvielli, and Bernstein (L Ruimi et al., under
review) found that real-time feedback on attention led to elevated meta-awareness of biased
attention (via Probe-Caught Meta-Awareness of Bias methodology; see Section III above),
greater regulation of overt (eye-movement) attentional processing of threat, and that greater
from internal experience (*Kross et al., 2017; see also Kross et al., 2014). Building on
(Kross & Ayduk, 2011), in these manipulations participants are instructed to use third-person
(name) vs. first-person (I) in written self-talk regarding a particular subject (e.g., worries
about Ebola). Consistent with the meta-cognitive processes model for mental health, Kross et
al (2017) found that, among participants worried about Ebola, disidentification from internal
experience elicited via third-person self-talk about Ebola (vs. first-person) was associated
with more rational thought about Ebola, reduced Ebola worry, and reduced perceived risk.
Conclusions
studies and methods are beginning to provide support for (1) the theorized inter-relations
thought content, (2) the pathways through which these meta-cognitive processes contribute to
mental health, as well as (3) theorized salutary roles of these processes as mechanisms of
action in MBIs. We note that in contrast to self-report research to-date, there has been very
limited study of decentering in MBIs using these emerging methods. Likewise, the review
tools to measure and study meta-awareness, and initial but fewer tools to measure and study
Looking forward, we foresee that research developing and utilizing such methods to study
decentering may also have promising translational implications. (1) To better specify the
vulnerability and improve mental health; (2) To guide the personalization of MBIs to engage
and move individual metacognitive processes and thereby to optimize the efficacy of such
and Just-In-Time Adaptive Intervention (JITAI) designs (e.g., Collins et al., 2014; *Nahum-
Shani et al., 2016); (4) To adapt measurement methods in order to train the metacognitive
processes as they unfold from moment-to-moment in time (e.g., real-time feedback to train
propose that by guiding the development and testing of key measurement and experimental
methods, the Metacognitive Processes Model of Decentering (*Bernstein et al., 2015) may
have important implications for advancing the science and practice of decentering.
Acknowledgements
This work was supported by the Israel Science Foundation (grant no. 2046/17,
Bernstein), a Mind and Life Institute Varela Award (grant no. 2015-Varela-Hadash,Yuval)
and NHLBI (grant no. 1R01HL119977, Fresco) & NINR (grant no. 1P30NR015326, Fresco).
Running Head: DECENTERING METHODS AND INSIGHTS 15
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