Breath versus Emotions: The Impact of Different Foci of Attention During
Mindfulness Meditation on the Experience of Negative and Positive Emotions

Thomas Beblo, Sarah Pelster, Christine Schilling, K. Kleinke, Benjamin

Iffland, Martin Driessen, Silvia Fernando

PII: S0005-7894(17)30136-3
DOI: doi:10.1016/j.beth.2017.12.006
Reference: BETH 773

To appear in: Behavior Therapy

Received date: 23 November 2016

Accepted date: 13 December 2017

Please cite this article as: Beblo, T., Pelster, S., Schilling, C., Kleinke, K., Iffland, B.,
Driessen, M. & Fernando, S., Breath versus Emotions: The Impact of Different Foci of
Attention During Mindfulness Meditation on the Experience of Negative and Positive
Emotions, Behavior Therapy (2017), doi:10.1016/j.beth.2017.12.006

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 ACCEPTED MANUSCRIPT
Running Head: Breath versus Emotions

Breath versus Emotions: The Impact of Different Foci of Attention During

Mindfulness Meditation on the Experience of Negative and Positive

Emotions

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Thomas Beblo, PhDa, b, Sarah Pelsterb, Christine Schillingb, Kleinke, K., PhDb,

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Benjamin Iffland, PhDb, Martin Driessen, MD, PhDa, b, & Silvia Fernando, PhDa

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Clinic of Psychiatry and Psychotherapy Bethel, Remterweg 69-71, 33617 Bielefeld, Germany
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Department of Psychology, University of Bielefeld, Universitätsstraße 25, 33615 Bielefeld, Germany

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Correspondence: Thomas Beblo

Division of Research

Clinic of Psychiatry and Psychotherapy

Ev. Hospital Bethel

Remterweg 69-71, 33617 Bielefeld, Germany

Tel.: ++49 521 772 78512, FAX: ++49 521 772 78511

E-Mail: thomas.beblo@evkb.de
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2 Breath versus Emotions

Abstract

Mindfulness meditation yields beneficial effects on the processing of emotions.

However, it is still unclear whether the focus of attention during meditation influences these

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effects. In the present study we aimed at comparing the effects of breathing meditation and

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emotion-focused meditation on the immediate and delayed processing of negative and

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positive emotions. The study included 65 adult novice meditators who were exposed to

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positively and negatively valenced film clips. Participants were randomly assigned to three

conditions. While watching the films at t1, they were asked to mindfully focus on their breath

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(condition 1), on emotions (condition 2), or on nothing in particular (condition 3). Ten
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minutes later at t2, comparable film clips were shown but all participants watched them

without taking up a mindful attitude. Dependent measures were emotional states at t1 and t2.

Participants of both meditation conditions particularly showed a more preferable delayed

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emotional reaction to negative stimuli than participants of the control condition. Breathing

meditation and emotion-focused meditation may constitute effective emotion regulation

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strategies to deal with negatively valenced emotional states.

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Keywords: mindfulness; meditation; positive emotions; negative emotions

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3 Breath versus Emotions

Introduction

Mindfulness has its origins in Buddhism and other Eastern meditative traditions.

Primarily in the context of the treatment program “Mindfulness-Based Stress Reduction”

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(MBSR; Kabat-Zinn, 1990), mindfulness has recently been incorporated into psychological

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as well as medical research and practice. Kabat-Zinn defined mindfulness as “the awareness

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that emerges through paying attention on purpose, in the present moment, and non

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judgmentally to the unfolding of experience moment by moment.” (p. 145; Kabat-Zinn,

2003). Although the practice of mindfulness was originally thought to be a life-long practice,

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research has demonstrated that even its application in the short-term has positive emotional
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consequences for healthy persons and patients (Grecucci, Pappaianni, Siugzdaite, Theuninck,

& Job, 2015).

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In a recent meta-analysis, Lamothe et al. (2016) summarized that MBSR is related to a

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more adaptive way to deal with emotions. MBSR leads to a reduction of burnout, stress,

anxiety, and depression and also to an increase of empathy. Robins et al. (2012) compared
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MBSR completers with a wait list control group and found significantly greater decreases in
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fear of emotions, suppression of anger, aggressive anger expression, worry, and difficulties
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regulating emotions. However, MBSR is a complex program that includes different types of

mindfulness-based exercises – for example the body scan, yoga, sitting meditation with

various meditation objects (such as breath, feelings, thoughts, body sensations, or open

awareness). It is not clear which exercises in particular contribute to better emotion

regulation.

With respect to sitting meditation, Erisman and Roemer (2010) exposed their

participants to emotionally negative, positive, and mixed film clips. After watching the films

for the first time, participants were randomly assigned to a mindfulness condition (brief

information about mindfulness and brief mindfulness-related exercises with a focus on

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4 Breath versus Emotions

breathing and emotions) or a control condition (psychoeducation). After this brief training,

participants watched the films for a second time. Participants of the mindfulness condition

reported significantly greater positive affect in response to the positive film, less negative

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affect in response to the mixed film and a trend for more adaptive emotion regulation in

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response to the mixed film. Reported effect sizes were medium to large. Brake et al. (2016)

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investigated patients with anxiety disorders who were assigned to a randomized order of

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blocks, utilizing either mindfulness- or avoidance-based strategies, while being exposed to

anxiety-related stimuli. In the mindfulness condition they were instructed to be aware of

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internal experiences such as feelings, thoughts, and body sensations. Patients reported less
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distress in the mindfulness condition versus the avoidance condition. These studies indicate

the beneficial effects of mindfully realizing the breath or internal states, such as emotions or
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thoughts. However, they did not differentiate between these different meditation objects.
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Arch and Craske (2006) compared the influence of breathing meditation, mind

wandering, and worrying on emotional responses to affectively valenced pictures and on the
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willingness to remain in contact with aversive pictures. While participants of the breathing
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group reported moderately positive responses to neutral pictures before and after the
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breathing exercise, the mind wandering and worrying groups responded more negatively to

neutral slides after their exercises. Later on, the breathing group showed a greater willingness

than the mind wandering group to view highly negative pictures. The authors, when

comparing contrasting mind states, concluded that mindfulness is related to a more adaptive

response to negative stimuli. Of note, apart from mindfulness per se breathing meditation also

includes other emotion regulation strategies that have been proved successful, in particular

distraction (Webb, Miles, & Sheeran, 2012). Strauss et al. (2016) investigated the immediate

effect of distraction on the processing of negative emotions triggered by negatively valenced

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5 Breath versus Emotions

pictures. Results indicated that distraction successfully decreased self-reported negative affect

relative to unpleasant passive viewing.

The emotional impact of exercises with other specific meditation objects has rarely

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been investigated. This is surprising because mindfully focusing on emotions might be an

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important exercise in mindfulness programs. It is known that exposure to emotions is an

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important mechanism of action in behavioral therapy (e.g., Hofmann, Mundy, & Curtiss,

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2015). While exposure is initially related to the experience of distress, emotional intensity

clearly decreases during the course of exposure and treatment (Hohagen, Stieglitz, Bohus,

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Caspar, & Berger, 2009). Delayed beneficial effects of the mindful focus on emotions is also
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suggested by a study of Campbell-Sills et al. (2006). The authors compared experiential and

physiological effects of emotion acceptance and suppression in patients with anxiety and
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mood disorders. Patients were randomly assigned to either accept or suppress their emotions.
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Then, they watched an emotion-provoking film and applied the instructions. Although both

groups reported similar levels of distress during the film, the acceptance group displayed less
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negative affect during the post-film recovery period. However, the instruction to accept
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possible upcoming emotions is not identical with mindful emotion-focused meditation.

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Although mindfulness implies the acceptance of inner experiences, it also includes other

qualities, e.g., decentering (the ability to view internal experiences with increased objectivity

and without identifying with these experiences) and kindness with respect to these

experiences (Chiesa, Anselmi, & Serretti, 2014; Grossman, 2015).

Taken together, a few studies suggest the general benefit of breathing meditation on

the processing of emotions and a few other studies suggest delayed positive effects of

emotion-focused meditation. However, it is unclear which of these mindfulness meditation

types might be preferable when faced with challenging emotions. To our knowledge, until

now no study has compared both types of mindfulness meditations. The aim of the present
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6 Breath versus Emotions

study is to investigate the immediate and delayed effects of breathing meditation, emotion-

focused meditation, and a passive viewing control condition on the processing of negative

emotions. We hypothesize that the immediate (Hypothesis 1) and delayed (Hypothesis 2)

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effects of breathing meditation on the processing of negative emotions are superior to the

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effects of the control condition. That is, participants of the breathing meditation condition

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show a less negative affective valence after exposure to negative stimuli (immediately and

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delayed) than participants of the control condition. Third, we hypothesize that the delayed

effects of emotion-focused meditation on the affective valence after exposure to negative

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stimuli is superior to the effects of the control condition. Fourth, we hypothesize that effects
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of breathing meditation on the immediate affective valence is superior to the effects of

emotion-focused meditation. For explorative reasons, we also included further dimensions of

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the affective experience (arousal and dominance) and investigated the affective response to
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positive stimuli in our study.

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Methods
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Participants
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According to a power analysis (G-Power; α = .05, power = .95, medium effect size:

partial ŋ2 = 0.06; focus on the main hypotheses 1 – 3) we aimed at including at least 54

participants in total (18 per group). To ensure minimum subsample sizes, we finally included

65 adult volunteers. Experienced meditators or people younger than 18 years or older than 65

years were not included. Participants were recruited through advertisements. In order to

appeal to as many people as possible, we kept the advertisements rather general (“For a

psychological study we are looking for participants”) but also mentioned the exclusion

criteria. Eligible recruits who agreed to participate in the study, were individually enrolled.

We obtained written and informed consent from all participants. Forty-one (63.1%)
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7 Breath versus Emotions

participants were female and 24 (36.9%) were male. On average, participants were 27.9 years

old (SD = 9.05, range = 18 - 62).

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Instruments

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Self-Assessment Manikin (SAM; Bradley & Lang, 1994; Lang, 1980): The SAM is a

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non-verbal pictorial assessment technique used to obtain self-assessments of the emotional

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state on the dimensions of affective valence, arousal, and dominance. Each dimension is

represented by one item that shows a picture of a manikin in five grades. Valence is

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operationalized by a manikin showing a rather negative or positive affective state. Arousal is
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operationalized by a manikin being more or less energetic, and dominance is operationalized

by showing a rather small (feeling of less dominance) or large manikin (feeling of much
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dominance). The manikins representing valence and arousal are shown in Figure 2 and Figure
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3. Despite the small item number, several studies indicate sufficient reliability of the SAM

(Backs, da Silva, & Han, 2005; Lang, Bradley, & Cuthbert, 2007). The SAMs’ validity was
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shown by high correlations with the Semantic Differential Scale (Bradley & Lang, 1994;
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Mehrabian & Russell, 1974).

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Kentucky Inventory of Mindfulness Skills (KIMS-D, Baer, Smith, & Allen, 2004;

Stroehle, Nachtigall, Michalak, & Heidenreich, 2010): The KIMS-D is a German adaption of

the KIMS (Baer et al., 2004). The inventory contains 39 items and measures four basic trait-

mindfulness skills: Observing (12 items), describing (8 items), acting with awareness (10

items), and accepting without judgment (9 items). The items of the German version (Stroehle

et al., 2010) were rated on a rating scale ranging from 1 (“applies to me never or very

rarely”) to 5 (‘‘applies to me always or very often”). According to Stroehle et al., the

KIMS-D provides satisfying reliability (Cronbach’s α = 0.82 [observing], 0.92 [describing],

0.79 [acting with awareness], 0.89 [accepting without judgment]. In addition, construct
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8 Breath versus Emotions

validity was shown by moderate correlations of the four subscales (r = 0.53 – 0.21) with

other mindfulness scales such as the Mindful Attention and Awareness Scale (MAAS)

(Brown & Ryan, 2003; Michalak, Heidenreich, Stroehle, & Nachtigall, 2008) and by negative

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correlations of the four subscales (r = - 0.59 – - 0.10) with psychopathological measures such

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as depression, as assessed with the Beck Depression Inventory (Beck & Steer, 1994;

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Hautzinger, Bailer, Worall, & Keller, 1994).

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Emotion Acceptance Questionnaire (EAQ; Beblo et al., 2011): The general (trait-

related) acceptance of positive and negative emotions was assessed by means of the EAQ.

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The EAQ contains 32 items divided equally by the two main subscales: acceptance of
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negative emotions and acceptance of positive emotions. Items were rated on a rating scale

ranging from 1 (“does not apply to me”) to 6 (‘‘applies to me completely”). Reliability was

estimated as high by Cronbach’s α of 0.91 for the total scale and 0.89 and 0.90 for the
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subscales acceptance of negative emotions and acceptance of positive emotions, respectively

(Beblo et al., 2011). In addition, construct validity was shown by moderate correlations of the
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total score and the subscale scores (r = 0.52 – 0.44) with the Difficulties in Emotion
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Regulation Scale (DERS) (Ehring, Tuschen-Caffier, Schnulle, Fischer, & Gross, 2010; Gratz
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& Roemer, 2004) and by moderate correlations of the total score and the subscale scores (r =

0.39 – 0.28) with a short version of the Symptom Checklist (Franke et al., 1995) (Beblo et al.,

2011). Reliability and validity was also confirmed in a clinical sample of depressed patients

(Beblo et al., 2012).

Procedure and Experimental Conditions

The procedure (Figure 1) parallels the paradigm of a study by Walter et al. (2009)

who investigated the short- and delayed effects of emotion regulation on emotional state.
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9 Breath versus Emotions

Baseline and Training (t0): After giving written and informed consent, participants

completed ratings about their current emotional state by means of the SAM. The participants

were then randomly assigned to one of the three experimental conditions and started with

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brief trainings (about 10 min). In condition 1, participants were instructed to focus mindfully

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on their breath (“breathing meditation”). In condition 2, they were instructed to focus

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mindfully on their emotions (“emotion-focused meditation”). Both instructions were based on

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guidelines from Erisman and Roemer (2010) and Mindfulness-Based Cognitive Therapy

(MBCT; Segal, Williams, & Teasdale, 2012). In condition 3 (passive viewing control

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condition), participants were told to imagine how they find relief by unburdening themselves
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from baggage, using a guided imagery procedure. This exercise was developed by

Reddemann (2010). To standardize the procedure across all experimental conditions,

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audiotaped instructions and stimulus presentation were performed on a standard laptop

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computer. The wording of the three conditions is presented in the appendix.

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- Please insert Figure 1 here -

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Deployed Mindfulness: First Presentation of the films (t1): After the training, we

administered the film paradigm, which included movie sequences with actors expressing fear

(negative films) or joy (positive films). The paradigm was based on a fearful face paradigm

developed by Schacher et al. (2006). Both films lasted 4 minutes and the order of the film

presentation (positive and negative) was randomized. That is, some participants watched the

positive films first and the other participants watched the negative films first. Pretests with 51

healthy participants indicated that negative films were rated significantly more negative than

neutral films (4.4 [0.33] > 3.1 [0.22]; t (50) = 22.7, p < 0.001, d = 4.50) while positive films
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10 Breath versus Emotions

were rated significantly more positive than neutral films (1.5 [0.33] < 3.1 [0.22]; t (50) =

25.2, p < 0.001, d = 5.00). With respect to the arousal ratings, pretests with the same 51

healthy participants indicated that negative films induced significantly more arousal than

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neutral films (1.7 [0.77] > 1.2 [0.55]; t (50) = 7.4, p < 0.001, d = 1.47). Positive films also

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induced significantly more arousal than neutral films (1.3 [0.66] > 1.2 [0.55]; t (50) = 2.4, p =

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0.018, d = 0.48).

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Participants of condition 1 were instructed to focus on their breath while watching the

films. Participants of condition 2 were instructed to focus on their emotions while watching

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the films, and participants of condition 3 were instructed to simply watch the films. During
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the film presentation, participants of condition 1 and 2 were reminded twice to focus on their

breath or their emotions, respectively. Just after the presentation of each film (the positive
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film and the negative film), the emotional state of the participants was assessed by means of
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the SAM (Lang, 1980). That is, participants rated their present affective valence, arousal, and

dominance. In addition, participants of the mindfulness conditions (focused on breathing or

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emotions) were asked how well they thought they held a mindful attitude during the viewing
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of the films.
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Passive Viewing: Second Presentation of the films (t2): After a ten minute break in

which the participants completed cognitive tests (results are not part of the present study), we

again administered the film paradigm with fearful and joyful faces, respectively. For this

second presentation, comparable film scenes were used, but both films lasted only 1.5

minutes each. The order of the presentation of both films (positive and negative)

corresponded to the first presentation at t1. In order to investigate the effect of the initial

emotion regulation strategy at t1 (focus on breath, focus on emotions, no particular strategy)

on the emotional response at a later moment (t2), at t2 all participants were instructed to just
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11 Breath versus Emotions

watch the films “naturally.” Just after the presentation of each film, the emotional state of the

participants was assessed by means of the SAM (Lang, 1980).

End of the study (t3): Participants were asked to complete the KIMS-D (Baer et al.,

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2004; Stroehle et al., 2010) for the assessment of trait-mindfulness, and the EAQ (Beblo et

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al., 2011) for the assessment of acceptance of negative and positive emotions. We presented

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these questionnaires at the end of the study in order to avoid their influence on the

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experiment.

Statistical Analyses
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Demographic data were compared between the three study groups by means of the

ANOVA (age) or the χ²-test (gender). Trait mindfulness and emotion acceptance were
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compared between the three study groups by the multivariate analysis of variance
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(MANOVA). All hypotheses focused on the interaction between time and group with respect

to the SAM-scale “valence”. They were tested by a 3x3 (Time by Group) repeated measures
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ANOVA and by hypothesis-specific contrasts. For explorative reasons, we also performed

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3x3 (time by group) repeated measures ANOVAs with respect to the remaining two SAM-
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scales (“arousal” and “dominance”) in response to negatively valenced films. We also

performed 3x3 (Time by Group) repeated measures ANOVAs with respect to the three SAM-

scales (“valence”, “arousal” and “dominance”) in response to positively valenced films.

All analyses were performed under a level of significance of  = .05. To correct for

violations of the sphericity assumptions, we used the Huynh-Feldt-method, when  > .75, and

the Greenhouse-Geisser method otherwise (cf. Girden, 1992). No adjustments for multiple

testing were made regarding the planned contrasts. For exploratory post hoc comparisons, we

adjusted the level of significance using the Sidak method. Effect sizes (d for t-Tests and

partial ŋ2 for analyses of variances) were provided for all t-Tests and Analyses of Variance.
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12 Breath versus Emotions

Results

Baseline Analyses and Manipulation Check

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As described above, participants were randomly assigned to three experimental

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conditions: (1) focus on breath, (2) focus on emotion, and (3) the passive viewing control

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condition. The respective groups were comparable in age, gender, and variables related to

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trait mindfulness (emotion acceptance with respect to both negative and positive emotions,

derived from the EAQ [Beblo et al., 2011]; and observing, acting with awareness, accepting

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without judgment, describing, derived from the KIMS-D [Baer et al., 2004; Stroehle et al.,

2010]; table 1). Participants of both mindfulness conditions reported medium success with
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maintaining a mindful attitude during the first film presentation (Breathing Meditation: m =

3.6, SD = 1.2; Emotion-Focused Meditation: m = 4.1, SD = 1.0 with 1 = very simple to focus
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on object and 6 = very hard to focus on object). Participants of both mindfulness conditions
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did not differ significantly in this regard (t (40) = 1.50, p = 0.14, d = 0.45).
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- Please insert table 1 here -

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Hypothesis-Related Results

All results are shown in table 2. Figure 2 illustrates affective valence of participants of

all conditions during the course of the experiment. Figure 2 shows that the affective valence

of participants of the control condition numerically worsened from t0 to t1 and from t1 to t2

when negatively valenced films were presented while the affective valence of participants of

the two mindfulness conditions numerically worsened from t0 to t1 but improved from t1 to

t2.
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- Please insert table 2 and Figure 2 here -

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Statistical analysis revealed a main effect of time (F (1.72, 106.46) = 11.66, p < 0.001,

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ŋ2 = 0.16) and of group F (2,62) = 4.60, p = 0.014, ŋ2 = 0.13). In accordance with our

hypotheses, affective valence in response to negatively valenced films differed in the three

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groups with respect to time (interaction Time x Group: F (3.43, 106.46) = 2.87, p = 0.032, ŋ2
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= 0.09). A follow-up simple effects analysis showed that initially at t0 there were no

significant differences in affective valence between either of the three groups (F (2,62) =
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1.13, p =0.33), which means that all participants showed a comparable (and rather positive)
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affective valence, when they started the study. With respect to the four hypotheses planned

contrasts were tested.

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Effects of Breathing Meditation on Affective Valence in Response to Negatively

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Valenced Films (Hypotheses 1 and 2): Predicted marginal means showed that affective

valence worsened in both groups from t0 (baseline) to t1 (immediately after film

presentation): From 2.10 to 2.76 in the breathing meditation group and from 2.04 to 2.78 in

the control group. The difference in change from t0 to t1 between both groups was not

statistically significant (δ = 0.08; F (1,62) = 0.03, p = 0.86). That is, Hypothesis 1, assuming a

positive immediate effect of breathing meditation on affective valence, was not confirmed by

the data.
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14 Breath versus Emotions

With respect to the delayed response, breathing meditation had a positive impact on

affective valence from t1 to t2 (after the second film presentation) when compared to the

control condition. A comparison of predicted marginal means revealed that from T1 to T2,

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affective valence improved for participants in the breathing meditation condition from 2.76 to

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1.95 while in the control condition affective valence further worsened from 2.78 to 2.96. In

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accordance with the second hypothesis, the difference in change from t1 to t2 between the

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breathing meditation group and the control group was statistically significant (δ = 0.99; F

(1,62) = 12.95, p < 0.001).

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Effects of Emotion-Focused Meditation on Affective Valence in Response to

Negatively Valenced Films (Hypothesis 3): We also hypothesized a positive delayed effect of
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emotion-focused meditation. From t1 to t2, affective valence improved for participants in the
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emotion-focused meditation condition from 3.14 to 2.86 while in the control condition,

affective valence further worsened from 2.78 to 2.96. The difference from t1 to t2 between
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the emotion-focused meditation group and the control group, however, was only marginally
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significant (δ = 0.46, F (1,62) = 2.83, p = 0.097).

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Breathing versus Emotion-Focused Meditation: Effects on Affective Valence in

Response to Negatively Valenced Films (Hypothesis 4): According to the fourth hypothesis,

immediate effects of breathing meditation on the experience of negative stimuli should be

superior to the effects of emotion-focused meditation. In the breathing meditation group,

affective valence worsened from an initial value of 2.10 (t0) to 2.76 (t1) and in the emotion-

focused meditation group, affective valence worsened from an initial value of 2.48 (t0) to

3.14 (t1). The worsening of affective valence by 0.66 units was the same for both groups.

This means that there was no difference in change of affective valence between T0 and T1
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15 Breath versus Emotions

when comparing the breathing meditation group and the emotion-focused meditation group (δ

= 0, F (1,62) = 0, p = 1).

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Explorative Results

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For explorative purposes, we also performed 3 (time: t0, t1, t2) x 3 (group: breathing

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meditation, emotion-focused meditation, control) ANOVAs with respect to arousal and

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dominance in response to negatively valenced films, and for affective valence, arousal, and

dominance in response to positively valenced films. Main effects and interactions are

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reported. With respect to post-hoc comparisons, only significant results are shown. All other
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results are available on request.

Effects of Breathing and Emotion-focused Meditation on Arousal in Response to

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Negatively Valenced Films (figure 3): There was a main effect of time (F (2,124) = 12.07, p
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< 0.001, ŋ2 = 0.16) but not of group F (2,62) = 2.61, p = 0.082, ŋ2 = 0.08). Arousal in

response to negatively valenced films differed in the three groups with respect to time
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(interaction Time x Group: F (4,124) = 3.32, p = 0.013, ŋ2 = 0.10). Post-hoc comparisons

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revealed that arousal of participants of the breathing meditation condition was lower than
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arousal of participants of the emotion-focused meditation condition at t1 (predicted difference

of marginal means = 0.86, p = 0.02). Further, arousal increased in participants of the

emotion-focused condition from t0 to t1 (predicted difference of marginal means = 0.76, p =

0.005) and in participants of the control condition (predicted difference of marginal means =

0.65, p = 0.014). However, arousal then decreased from t1 to t2 only in participants of the

emotion-focused meditation condition (predicted difference of marginal means = 1.000, p <

0.001).
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16 Breath versus Emotions

- Please insert Figure 3 here -

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Effects of Breathing and Emotion-focused Meditation on Dominance in Response to

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Negatively Valenced Films: There was a main effect of time (F (2,124) = 5.29, p = 0.006, ŋ2

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= 0.08) but not of group F (2,62) = 1.22, p = 0.30, ŋ2 = 0.04). Posthoc analyses revealed that

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dominance in response to negatively valenced films decreased from t0 to t1 (predicted

difference of marginal means = 0.26, p = 0.024) and increased from t1 to t2 (predicted

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difference of marginal means = 0.24, p = 0.018). Dominance in response to negatively
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valenced films did not differ in the three groups with respect to time (no interaction Time x

Group: F (4,124) = 1.28, p = 0.28, ŋ2 = 0.04).

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Effects of Breathing and Emotion-focused Meditation on Affective Valence in

Response to Positively Valenced Films: There was a main effect of time (F (2,124) = 9.00, p
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< 0.001, ŋ2 = 0.13) but not of group F (2,62) = 2.22, p = 0.12, ŋ2 = 0.07). Posthoc analyses
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revealed that affective valence in response to positively valenced films improved from t0 to
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t1 (predicted difference of marginal means = 0.46, p = 0.003) and worsened from t1 to t2

(predicted difference of marginal means = 0.47, p < 0.001). Affective valence in response to

positively valenced films did not differ in the three groups with respect to time (no interaction

Time x Group: F (4,124) = 0.86, p = 0.49, ŋ2 = 0.03).

Effects of Breathing and Emotion-focused Meditation on Arousal in Response to

Positively Valenced Films: There was no main effect of time (F (2,124) = 0.61, p = 0.55, ŋ2 =

0.01) and no main effect of group F (2,62) = 0.45, p = 0.64, ŋ2 = 0.01). However, arousal in

response to positively valenced films differed in the three groups with respect to time
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17 Breath versus Emotions

(interaction Time x Group: F (4,124) = 3.10, p = 0.018, ŋ2 = 0.09). Post-hoc comparisons

revealed that arousal decreased in participants of the emotion-focused condition from t1 to t2

(predicted difference of marginal means = 0.62, p = 0.019).

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Effects of Breathing and Emotion-focused Meditation on Dominance in Response to

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Positively Valenced Films: There was also no main effect of time (F (2,124) = 2.65, p =

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0.075, ŋ2 = 0.041) and no main effect of group F (2,62) = 0.30, p = 0.74, ŋ2 = 0.01). Also,

dominance in response to positively valenced films did not differ in the three groups with

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respect to time (no interaction Time x Group: F (4,124) = 0.75, p = 0.56, ŋ2 = 0.02).
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Discussion
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Although the practice of mindfulness was originally thought to be a life-long practice,

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studies have demonstrated positive emotional consequences even in the short - term

(Grecucci et al., 2015). However, research has neglected comparing different mindfulness-
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based meditation types in order to establish their potentially differential impact on emotions.
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In the present study, we investigated the immediate and delayed effects of breathing
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meditation, emotion-focused meditation, and a passive viewing control condition on the

processing of negatively and positively valenced stimuli in novice meditators. Participants in

the breathing meditation condition showed a comparable immediate affective valence in

response to negative stimuli when compared to control participants (unlike the prediction of

hypothesis 1). However, arousal increased in participants of the control condition but not in

participants of the breathing meditation condition, indicating an immediate emotional benefit

for participants of the breathing meditation condition. In addition, participants of the

breathing meditation condition reported significantly less negative affective valence later on

than control participants (in agreement with hypothesis 2). Participants of the emotion-
 ACCEPTED MANUSCRIPT
18 Breath versus Emotions

focused meditation condition also seemed to show a less negatively valenced delayed

emotional response than was shown by control participants (partial confirmation of

hypothesis 3). This result is supported by a significant delayed (from t1 to t2) decrease of

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arousal in the emotion-focused meditation group. When participants of both meditation

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conditions were compared with respect to their immediate emotional response, participants of

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the breathing condition showed less arousal in response to the negative films than participants

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of the emotion-focused meditation condition, indicating a more preferable immediate

emotional response. However, they did not report a less negative affective valence as

incorrectly predicted by hypothesis 4.

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In general, our results are in agreement with other studies demonstrating the beneficial

effects of mindfulness meditation on emotions (Goyal et al., 2014; Khoury, Sharma, Rush, &
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Fournier, 2015). However, our study indicates that these effects occur primarily in the
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aftermath, but not exclusively. This specification does not conflict with existing studies (Arch

& Craske, 2006; Erisman & Roemer, 2010) and confirms the results of Campbell-Sills et al.
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(2006). Cho et al. (2016) assessed the emotional response of students who were, first,
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exposed to negative pictures and then to neutral pictures. They found that the disposition of
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mindful attention was not associated with negative emotion in the immediate response to

negative stimuli but with reduced negative emotions later on (when neutral stimuli were

presented). In agreement with the results of our study, the authors concluded that mindfulness

predicted a greater recovery from negative emotions but not reduced reactivity to negative

stimuli. By contrast, some other studies did suggest immediate effects of mindfulness

meditation. In a fMRI study with healthy participants, Herwig et al. (2010) investigated the

neural correlates of cognitive self-reflection, emotion-introspection, and of a neutral

condition. When compared to the neutral condition, amygdala activity decreased during

emotion - inspection and increased during cognitive self-reflection. These findings suggest
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19 Breath versus Emotions

that the mindful awareness of emotions may lead to an immediate attenuation of emotional

arousal. However, as Herwig et al. did not induce negative emotions, the study does not allow

for conclusions about the temporal mode of action with respect to mindfulness and negative

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emotions. In patients with anxiety disorders, Brake et al. (2016) found immediate positive

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effects of mindfulness (with a focus on different objects) on distress in response to anxiety

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related stimuli. The difference between this outcome and our results might be explained by

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the different study samples. As mindfulness meditation appears to yield greater anxiety-

related effects in patients with anxiety disorders, than in persons without anxiety disorders

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(Hofmann, Sawyer, Witt, & Oh, 2010), the beneficial effects of mindfulness might be more
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profound in the Brake et al. study than in our study.

As our study did not focus on the mechanism of action, we can only speculate about
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underlying mechanisms. At first, the positive results of both meditation conditions suggest
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that mindfulness itself is beneficial for the emotional response to negative stimuli. More

specifically, mindful awareness (applied by novices) does not appear to primarily influence
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the immediate emotional response to negative stimuli. Instead, mindful awareness may
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particularly help to prevent (secondary) negative emotions that develop in the aftermath from
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dysfunctional reactions to (primary) emotions. Several mechanisms of action have been

suggested that correspond to this perspective, e.g. decentering (Holzel et al., 2011; van der

Velden et al., 2015). In meditation novices, Feldman et al. (2010) compared the effects of

mindfulness (breathing) meditation to the effects of loving kindness meditation and the

effects of progressive muscle relaxation on three variables: decentering, the frequency of

repetitive thoughts (e.g., worries or ruminative thoughts that typically lead to secondary

negative emotions), and the degree of negative reaction to thoughts. The results revealed that

participants in the mindfulness meditation condition reported greater decentering relative to

the other two conditions. In addition, the relation between the frequency of repetitive
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20 Breath versus Emotions

thoughts and negative reactions to thoughts was relatively weaker in the breathing meditation

condition than in the other conditions. Thus, decentering may enable meditators to see

dysfunctional thoughts just as mental phenomenas that do not need to be taken so seriously.

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With respect to the comparison between participants of the breathing and emotion-

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focused condition, our results indicate in parts a more preferable immediate emotional state in

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participants of the breathing condition. They showed less arousal in response to the negative

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films than participants of the emotion-focused meditation condition (but not a less negative

affective valence). The more preferable immediate emotional state in participants of the

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breathing condition might be explained by the fact that breathing meditation offers distraction
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from emotional content (Webb et al., 2012). By contrast, emotion-focused meditation leads to

direct exposure to emotions with delayed positives effects on the emotional state (Hayes &
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Feldman, 2004; Roemer & Orsillo, 2002) but direct exposure to emotions also leads to
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immediate distress (Hofmann et al., 2015; Hohagen et al., 2009). However, it is unclear why

these factors were only related to arousal but not to the valence dimension of the emotional
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state.
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The results of the present study have clinical implications. Mindfulness-based

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meditation techniques have the ability to improve emotional well-being when negative

emotions get triggered. Our results suggest that focusing on breathing and focusing on

emotions have positive effects. However, the results of breathing meditation were slightly

better than the results of emotion-focused meditation. Only the positive effect of breathing

meditation on affective valence was statistically secured and only breathing meditation

appeared to have immediate positive effects on arousal. The value of mindfulness meditation

is also reported by authors who compared the effects of mindfulness meditation and cognitive

reappraisal on the emotional state. Cognitive reappraisal is known to be one of the most

investigated and effective emotion regulation strategies in healthy participants and in

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21 Breath versus Emotions

different groups of psychiatric patients (Cutuli, 2014). Keng et al. (2013) found that the

mindful awareness of thoughts and emotions lead to similar effects on the emotional state as

cognitive reappraisal but cognitive reappraisal was related to higher cognitive costs. Hayes-

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Skelton and Graham (2013) reported that habitual cognitive reappraisal and habitual

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mindfulness are negatively related to anxiety via similar but also different mechanisms.

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However, future studies need to investigate the effects of mindfulness under more serious

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emotional conditions (e.g., in serious, real-life situations such as before exams, in laboratory

settings with more intrusive paradigms, and in more challenged participants such as patients

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with mental disorders). These studies need to verify whether clinicians should make
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breathing meditation and / or emotion-focused meditation available to patients in emotionally

challenging situations.
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Our study has several strengths such as the randomized experimental design, and the
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consideration of immediate and delayed reactions. However, some limitations also have to be

discussed. Size of the subgroups and statistical power were rather small. This shortcoming
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might have prevented us from detecting further effects. In addition, at t1 the design of the
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study provides instructed mental activity for participants of the breathing and emotion-
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focused condition apart from watching the films (“dual-tasking”), but not for participants of

the control condition (“monotasking”). Thus, it cannot not be excluded that the effects of our

study were in some parts related to this factor. However, it is hard to explain why possible

effects caused by an instruction are primarily operant during the later phase of the experiment

where no instructions were given (delayed emotional response, t2) but barely operant during

the early phase of the experiment when the instructions were given (t1). Further, the

instructions for the participants of the breathing and emotion-focused conditions were only

operant for the first time they watched the films but not for the second time. By contrast,

participants of the control condition watched the films both times under the same
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22 Breath versus Emotions

circumstances (no instruction). Possibly, this change of processing mode might have

influenced the study results.

In conclusion, breathing meditation and emotion-focused meditation may constitute

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effective emotion regulation strategies to improve the emotional response to negatively

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valenced stimuli. The effects of both mindfulness meditations appear to be similar with few

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advantages for the breathing meditation. Thus, both meditations may contribute to beneficial

SC
effects of mindfulness based therapy programs such as MBSR. Future studies need to

investigate the effects of mindfulness on more intense emotional states to verify whether

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clinicians should make breathing meditation and / or emotion-focused meditation available to
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patients in emotional challenging situations.
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Ethical Statement
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The authors assert that all procedures contributing to this work comply with the

ethical standards of the relevant national and institutional committees on human

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experimentation and with the Declaration of Helsinki of 1975, and its most recent revisions.
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The study was approved by the University of Bielefeld Ethics Committee.

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Conflict of Interest

The authors declare that there are no conflicts of interest

Financial Support

This research received no specific grant from any funding agency, commercial, or not-

for-profit sectors.
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23 Breath versus Emotions

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Appendix

A Breathing meditation (based on Erisman & Römer, 2010)

First, bringing yourself to sit in an upright position... just allowing your eyes to close

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gently... noticing how you are sitting in the chair… noticing where you are touching the

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chair, where you are touching the floor… noticing where the air is touching your skin and

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what that feels like… and now gently drawing your attention to your breath... noticing

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(without trying to change it) where your breath is coming from… noticing where it enters

your body when you inhale… how it travels through your body before you exhale… maybe

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even noticing a pause in between… noticing how your body moves… with each inhalation,
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each exhalation… focusing your attention on the place where your breath feels strongest…

allowing any thoughts or feelings that occur to naturally rise and fall… without trying to hold

onto them or get rid of them… just continue bringing your awareness to your breath as you
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allow whatever comes to come and whatever goes to go and whatever stays to stay…
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…spending a few minutes just focusing your attention on your breath...

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AC

…noticing how breath travels into your body, and back out of your body…

…and again bringing your awareness to the room… to the way you are sitting in the chair…

and gradually opening your eyes when you are ready and letting the experimenter know you

are ready to continue…

B Emotional-Focused Meditation (based on Erisman & Römer, 2010)

First, bringing yourself to sit in an upright position... just allowing your eyes to close

gently... begin by noticing how you are sitting in the chair… noticing the places where you
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31 Breath versus Emotions

are touching the chair, the places where you are touching the floor… noticing where the air is

touching your skin and what that feels like… and now gently drawing your attention to your

body sensations… turning towards any feelings that occur… just experiencing and allowing

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them to pass, without losing yourself in it... encountering them with a positive attitude…

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accepting them just how they are… notice how your feelings come up without judging them

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or trying to change them…

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…allow any feelings that occur to naturally rise and fall… without trying to hold onto them

or get rid of them… just continue bringing your awareness to your sensations as you allow

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whatever comes to come and whatever goes to go and whatever stays to stay…
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…spending a few minutes just focusing your attention on your feelings...
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TE

…if anytime you notice yourself distracted by thoughts or anything else, just guide your

awareness back to your feelings…

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CE

…noticing, what your feelings are like and allowing them to naturally come and go…
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…and again bringing your awareness to the room… to the way you are sitting in the chair…

and gradually opening your eyes when you are ready and letting the experimenter know you

are ready to continue…

C Control Condition (based on Reddemann, 2010)

Bringing yourself to sit in an upright position… just allowing your eyes to close

gently…
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32 Breath versus Emotions

…imagine yourself on a long travel… being loaded with heavy baggage… (…) on this long

travel you are reaching a plateau, a flat highland area… and because there is no need to climb

up anymore, you can take a breath… deciding to put down your baggage… (…) looking for a

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place to store your baggage… maybe on a rock or a tree… for now, freeing yourself from

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your baggage…

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SC
…and after putting down your baggage, feeling the ease, maybe you like to move or even

dance, feeling how light you have become… (…) and feeling that ease, becoming curious

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about what is around you, you are looking around…
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… not far away, making out something bright… which might be a light and feeling attracted

by that light, you decide to go towards it… reaching a place with warm, bright light… feeling
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you like to linger… looking for a spot where you can sit down and rest… or maybe you like

to take a walk or keep on dancing… in any case, you will find what is right for you… (…)
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and at the same time, still taking in the bright light, feeling comfortable and your body
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warming up… you enjoy the ease that you are still feeling…
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…suddenly, noticing some friendly, bright being coming up to you, smiling at you and

presenting a gift... you are getting a gift which, to your astonishment, is useful for your

problems that you currently experience, something that supports you now… maybe it is a

symbolic gift not making sense to you at this moment… if you feel glad about it, you can say

thank you… (…) now you decide to return to your baggage, leaving this place… knowing

though, that it is possible to come back anytime…

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…now, returning to your baggage, think about which part of your baggage you like to take

along on your further way… what you really need from now on… maybe noticing things that

you do not need anymore… (…) or taking everything with you, which is also fine…

T
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…then, you continue your journey carrying the baggage that you still need… knowing from

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now on that you can take a break and put down your baggage at any time…

SC
…and again bringing your awareness to the room… to the way you are sitting in the chair…

NU
and gradually opening your eyes when you are ready and letting the experimenter know you
MA
are ready to continue…
D
P TE
CE
AC
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34 Breath versus Emotions

T0 Training T1 T2 T3
Baseline Watching Films Watching Films End

Focus on Breath
Randomisation

T
Focus on Emotion Just View

IP
Just View (Control)

R
SAM SAM (after pos. films) SAM (after pos. films) KIMS

SC
SAM (after neg. films) SAM (after neg. films) EAQ

SAM: Self Assessment Manikin, KIMS: Kentucky Inventory of Mindfulness Skills, EAQ: Emotion Acceptance

NU
Questionnaire MA
Figure 1: Procedure
D
P TE
CE
AC
 ACCEPTED MANUSCRIPT
35 Breath versus Emotions

Standard error (SE)

Condition 1 (Focus on Breath)

Condition 2 (Focus on Emotion)

T
5
Condition 3 (Control)

IP
4,5

R
SC
4

3,5

3
NU
MA
2,5

2
D

1,5
TE

1
P

t0 t1 - Negative Film t2 - Negative Film

(Baseline) (Deployed Mindfulness) (Passive Viewing)
CE
AC

Figure 2: Valence of Affective Responses to Negative Films at t0 (Baseline), t1 (Deployed

Mindfulness), and t2 (Passive Viewing) of Participants of Condition 1 (Focus on Breath),

Condition 2 (Focus on Emotion), and Condition 3 (Control)

 ACCEPTED MANUSCRIPT
36 Breath versus Emotions

Standard error (SE)

Condition 1 (Focus on Breath)

Condition 2 (Focus on Emotion)

T
5,00
Condition 3 (Control)

IP
4,50

R
4,00

SC
3,50

NU
3,00
MA
2,50

2,00
D

1,50
TE

1,00
t0 t1 - Negative Film t2 - Negative Film
P

(Baseline) (Deployed Mindfulness) (Passive Viewing)

CE

Figure 3: Arousal of Emotional Responses to Negative Films at t0 (Baseline), t1 (Deployed

AC

Mindfulness), and t2 (Passive Viewing) of Participants of Condition 1 (Focus on Breath),

Condition 2 (Focus on Emotion), and Condition 3 (Control)

 ACCEPTED MANUSCRIPT
37 Breath versus Emotions

Table 1

Statistics of Demographic Data and Trait Mindfulness/ Emotion Acceptance in Participants

of the Breathing-Focused Group, the Emotion-Focused Group and the Passive Viewing
Control Condition

T
Breathing Emotion Control Statistics Effect
Focus Focus Sizes

IP
n = 21 n = 21 n = 23
Gender 57% women 71% women 61% women Chi2=1 0.61

R
M SD M SD M SD F p ŋ2

SC
Age 27.1 7.6 29.3 10.2 27.9 9.1 0.34 0.71 0.01

Ac. Negative Emotionsa

NU
3.9 0.8 3.8 0.6 4.1 0.9

Ac. Positive Emotionsa 5.3 0.4 4.8 0.9 5.1 0.7

MA
Observingb 43.6 6,1 38.2 7.6 41.1 6.7
1.42 0.17 0.13
b
Acting with Awareness 30.4 6.6 28 5.9 28.3 5.4

Ac. without judgmentb 34.1 5.6 32.7 7.9 34.2 6.5

D

Describingb 29.5 5.9 24.2 3.7 27.9 6.5

P TE

a
Derived from the Emotion Acceptance Questionnaire (EAQ, Beblo et al., 2011). Please note: Scores were
CE

devided by the number of respective items

b
Derived from the Kentucky Inventory of Mindfulness Skills (KIMS-D, Baer, Smith, & Allen, 2004; Stroehle,
Nachtigall, Michalak, & Heidenreich, 2010)
AC

2
Ac. = Accepting; ŋ = Partial Eta Squared
 ACCEPTED MANUSCRIPT
38 Breath versus Emotions

Table 2

Emotional Reactions to Negatively and Positively Valenced Films of the Three Study Groups

Breathing Emotion Control Statistics

T
Focus Focus n = 23
n = 21 n = 21

IP
T0 T1 T2 T0 T1 T2 T0 T1 T2 F p ŋ2
Negativ Valence1 2.1 2.8 2.0 2.5 3.1 2.9 2.0 2.8 3.0 11.66 0.0 0.1

R
T
ely (1. (0. (0. (1. (0. (0. (1. (0. (0. 01 6
G
Valence 0) 9) 9) 0) 9) 7) 0) 8) 8) 4.91 0.0 0.1

SC
d 2.78 14 3
TxG:
Films 0.0 0.0
32 8

NU
Arousal2 2.4 2.5 2.0 2.6 3.4 2.4 2.2 2,8 2.6 12.07 0.001 0
T
(1. (1. (1. (0. (0. (0. (0. (0. (0. 0.082 .
G
1) 0) 0) 9) 9) 7) 7) 9) 8) 2.61 0.013 1
MA
3.32 6
TxG
0
.
0
8
D

0
TE

.
0
1
P

Domina 3.2 2.9 3.4 3.0 2.9 3.0 3.1 2.8 2.9 5.29T 0.006 0
nce3 (0. (0. (0. (0. (0. (0. (0. (0. (0. 1.22G 0.30 .
CE

7) 8) 7) 6) 6) 6) 6) 8) 7) 1.28T 0.28 0
xG
8
0
AC

.
0
4
0
.
0
4
Positive Valence1 2.1 1.8 2.4 2.5 1.9 2.3 2.0 1.5 1.9 9.00T 0.001 0
ly (1. (0. (0. (1. (1. (1. (1. (0. (0. 2.22G 0.12 .
Valence 0) 7) 9 0) 0) 0) 0) 7) 9) 0.86T 0.49 1
xG
d 3
Films 0
.
0
7
0
.
0
 ACCEPTED MANUSCRIPT
39 Breath versus Emotions

3
2 T
Arousal 2.4 2.0 2.3 2.6 2.7 2.1 2.2 2.3 2.4 0.61 0.55 0
(1. (1. (1. (0. (0. (1. (0. (1. (1. 0.45G 0.64 .
1) 0) 1) 9) 8) 0) 7) 0) 0) 3.10T 0.018 0
xG
1
0

T
.
0

IP
1
0

R
.
0

SC
9
Domina 3.2 3.3 3.1 3.0 3.2 3.1 3.1 3.3 3.3 2.65T 0.075 0
nce3 (0. (0. (0. (0. (0. (0. (0. (0. (0. 0.30G 0.74 .

NU
7) 9) 6) 6) 7) 5) 6) 5) 6) 0.75T 0.56 0
xG
4
0
MA
.
0
1
0
D

.
0
TE

1
Higher values indicate a more negative affective valence, 2Higher values indicate more arousal, 3Higher values
P

indicate more dominance

T = Main effect “Time”, G = Main effect “Group”, TxG = Time x Group interaction, ŋ2 = partial eta squared
CE
AC
 ACCEPTED MANUSCRIPT
40 Breath versus Emotions

Highlights

1. Breathing meditation yields beneficial effects for negative emotions.

T
2. Emotion-focused meditation tends to yield similar delayed effects.

IP
3. Effects primarily affected the delayed emotional response.

R
4. Effects affected both, emotional valence and arousal.

SC
NU
MA
D
P TE
CE
AC