Running Head: DECENTERING METHODS AND INSIGHTS 1

Metacognitive Processes Model of Decentering: Emerging Methods and Insights

Amit Bernsteina

Yuval Hadasha

David M. Frescob

a
University of Haifa
b
Kent State University

Preprint submitted for publication in Current Opinion in Psychology Special Issue on

Mindfulness

Author Note

Amit Bernstein & Yuval Hadash, Department of Psychology, University of Haifa,

Mount Carmel, Haifa, 31905, Israel.

Yuval Hadash electronic mail: yuvalhadash@gmail.com

David Fresco electronic mail: fresco@kent.edu

Correspondence concerning this article should be addressed to Amit Bernstein:

abernstein@psy.haifa.ac.il (electronic mail), 972-4-828-8863 (phone), 972-4-824-0966

(facsimile).
Running Head: DECENTERING METHODS AND INSIGHTS 2

Abstract

We previously proposed that three metacognitive processes – meta-awareness,

disidentification from internal experience, and reduced reactivity to thought content –

together constitute decentering. We review emerging methods to study these metacognitive

processes and the novel insights they provide regarding the nature and salutary function(s) of

decentering. Specifically, we review novel psychometric studies of self-report scales of

decentering, as well as studies using intensive experience sampling, novel behavioral

assessments, and experimental micro-interventions designed to target the metacognitive

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

preliminary evidence of their salutary role as mechanisms of action in mindfulness-based

interventions.

Key Words: Behavioral assessment, Cognitive defusion, Decentering, Experience Sampling,

Identification, Meta-Awareness, Metacognitive Processes, Micro-Intervention, Mindfulness,

Reactivity, Self-Distanced Perspective

Highlights

 We propose that three metacognitive processes constitute decentering

 Experience sampling and behavioral tasks advance knowledge of decentering

 Micro-interventions advance experimental study of decentering

 Findings provide empirical support for the metacognitive model of decentering

 Findings elucidate pathways through which decentering contributes to mental health

Running Head: DECENTERING METHODS AND INSIGHTS 3

Introduction

Decentering reflects the capacity to shift experiential perspective – from within one’s

subjective experience, onto that experience. Decentering is theorized to function as a

malleable causal mediating process underlying salutary effects of various psychological

interventions as well as mindfulness-based interventions (MBIs) in particular (Beck et al.,

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

proposed the Metacognitive Processes Model of Decentering (*Bernstein et al., 2015).

Specifically, we proposed that three interrelated metacognitive processes – Meta-Awareness,

Disidentification from Internal Experience, and Reduced Reactivity to Thought Content –

together constitute the mental phenomenon commonly referred to as decentering (see Figure

1 and *Bernstein et al., 2015). Meta-awareness is awareness of subjective experience (i.e.,

awareness of the processes occurring in consciousness such as thinking, feeling, sensing;

*Dahl, Lutz & Davidson, 2015; *Smallwood & Schooler, 2015). It is distinguished from

awareness of the contents of thoughts (i.e., metal representations) without concurrent meta-

awareness of the thinking process. Disidentification from internal experience is the

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.,

attention, emotion, cognitive elaboration, motivation, motor planning) and is expressed in a

Running Head: DECENTERING METHODS AND INSIGHTS 4

number of ways such as reduced belief in thought content.

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

Fig1. The Metacognitive Processes Model of Decentering. Meta-awareness is

theorized to engender disidentification from internal experience and reduced reactivity

to thought content, which in turn affect one another, and feedback to reinforce meta-

awareness (Bernstein et al., 2015).

Bernstein et al (2015) also reviewed extant research on decentering and related

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

limited primarily by reliance on empirically modest methods (e.g., retrospective self-report,

cross-section designs). The development of methods to more rigorously and precisely

Running Head: DECENTERING METHODS AND INSIGHTS 5

measure and experimentally target the specified metacognitive processes of decentering

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

health. Accordingly, in the present commentary, we review recent methodological advances

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

mechanisms research including: (I) recent psychometric studies of self-report scales of

decentering and related constructs, (II) intensive experience sampling study of the

metacognitive processes of decentering, (III) behavioral assessment studies of the

metacognitive processes, and (IV) research using experimental micro-interventions designed

to target the metacognitive processes.

Table 1. Proposed Metacognitive Processes Across Decentering-Related Constructs

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-

related constructs (Bernstein et al., 2015).

I. Self-Report Scales: Measurement Structure

Two independent psychometric studies focused on better understanding the construct

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

meta-awareness of experience – labeled “Intentional Decentered Perspective” (Hadash et al.,

2017) and “Observer Perspective” (Naragon-Gainey & DeMarree, 2017), respectively. A

second factor reflecting reduced reactivity to thought content – labeled “Automatic Reactivity

to Thought Content” (Hadash et al., 2017) and “Reduced Struggle with Inner Experience”

(Naragon-Gainey, DeMarree, 2017), respectively. These findings have numerous

implications of self-report study of decentering. First, no single or group of existing self-

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.

Consistent with the metacognitive processes model and conceptualization of decentering,

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

guided by the metacognitive processes model.

II. Intensive Experience Sampling

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).

Accordingly, a recent study conducted intensive ES of meta-awareness (mindfulness),

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

content collected pre-intervention). As predicted by the metacognitive processes model,

mindfulness meditation, in which participants intentionally cultivated meta-awareness, was

associated with reduced reactivity to negative self-referential thought content, in the form of

greater willingness to experience these thoughts. This finding is particularly noteworthy as

the degree of distress elicited by the thoughts remained elevated and unchanged over the

course of the intervention.

III. Behavioral Assessment

Meta-Awareness

Several behavioral assessment methods have been developed to study meta-

awareness. For a review of extant behavioral measures of mindfulness and 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

meditation to assess meta-awareness of mind wandering (*Hadash & Bernstein, in press;

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

wandering on attentional/executive dysregulation (e.g., response inhibition, capacity to

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.,

content of mind wandering).

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.,

third-person; e.g., physiological, behavioral) markers of, or experimental manipulations of,

that experience. This method is used to measure accurate meta-awareness of subtle changes

in interoceptive and mental experience (see also interoceptive sensitivity/accuracy tasks;

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-

awareness of biased or dysregulated attention. Probe-caught ES are applied to estimate real-

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.,

third-person performance data). A signal detection methodology is applied to quantify

accurate detection or meta-awareness of biased attention through agreement between the

subjective ES reports of biased attention with objective performance data. Ruimi et al (2018)

found that momentary micro-expressions of biased attention without meta-awareness were

more likely followed by attentional dysregulation; whereas momentary micro-expressions of

biased attention with accurate meta-awareness were more likely followed by more balanced

attentional expression or greater attentional regulation. Consistent with the metacognitive

Running Head: DECENTERING METHODS AND INSIGHTS 10

processes model, findings suggest that accurate meta-awareness effects attentional regulation,

and important processes related to mental health.

A third approach to measure and study meta-awareness is implemented in the Mindful

Awareness Task – a phenomenological and behavioral measure of meta-awareness during

mindfulness meditation (see Hadash & Bernstein, in press, this issue for details). In the MAT

participants provide real-time self-caught reports (behavioral markers) of their meta-

awareness during mindfulness meditation, by verbally stating a label describing each

experience they notice (e.g., “hearing”, “thinking”) and by pressing a button when they notice

their inhalation and exhalation. Meta-awareness of different types of experience – bodily

sensations, mental events, pleasant experience, unpleasant experience – is measured via

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

reengagement in meta-awareness after mind wandering). Findings suggest that meta-

awareness of different objects of experience during mindfulness meditation are differentially

associated with mental health outcomes (e.g., meta-awareness of mental experience predicted

higher levels of self-regulation, and meta-awareness of pleasant experience predicted positive

affect). Moreover, faster re-engagement in meta-awareness following the onset of mind

wandering predicted higher levels of self-regulation and lower levels of depression symptoms

(Y Hadash et al., presentation in International Conference on Mindfulness, Amsterdam, July

2018).

Disidentification from Internal Experience

To study disidentification from internal experience (and related processes), *Hadash,

Plonsker, Vago and Bernstein (2016) developed the Single Experience & Self-Implicit

Association Test. This paradigm involves the experimental elicitation of a subjective

Running Head: DECENTERING METHODS AND INSIGHTS 11

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

emotions and trait decentering.

Reduced Reactivity to Thought Content

To measure reactivity to one’s own thought content, Amir, Ruimi and Bernstein (I

Amir et al., presentation in International Conference on Mindfulness, Amsterdam, July 2018)

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

negative emotional reactivity to idiographic negative self-referential thought content

predicted difficulty disengaging attention from negative self-referential thoughts to the

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

metacognitive processes model of decentering that implicates (emotional and attentional)

reactivity to thought content in mental health problems, and helps specify pathways through

which reduced reactivity to thought content may affect mental health.

Running Head: DECENTERING METHODS AND INSIGHTS 12

IV. Experimental Micro-Interventions

Micro-interventions or brief experimental methods designed to target and manipulate

the metacognitive processes help test causal relations between the processes and between the

processes and mental health. Such methods may also ultimately demonstrate therapeutic

implications and applications. One recent micro-intervention approach – Attentional

Feedback Awareness & Control Training – delivers real-time feedback on moment-to-

moment (i.e., trial-level) expressions of attention to train meta-awareness of biased or

dysregulated attention and thereby self-regulatory control of (biased) attention and/or

behavior driven by biased attention (Bernstein & Zvielli, 2014). Randomized controlled

experimental studies found that, among anxious adults, real-time feedback was associated

with improved regulation of covert (reaction time) attentional processing of threatening

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

levels of meta-awareness following training predicted greater capacity to regulate attention.

Consistent with the metacognitive processes model, findings provide preliminary

experimental evidence that meta-awareness contributes to attentional and emotional

regulatory processes implicated in mental health.

A second recent micro-intervention approach entails a language-based first- and third-

person self-talk manipulations to experimentally elicit self-distancing and disidentification

from internal experience (*Kross et al., 2017; see also Kross et al., 2014). Building on

seminal imaginal self-distancing and -immersion experimental micro-intervention methods

Running Head: DECENTERING METHODS AND INSIGHTS 13

(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

We selectively reviewed studies adopting novel methods to study decentering

including, latent structural study of self-report scales, intensive experience sampling,

behavioral assessments, and experimental micro-intervention methods. We found that these

studies and methods are beginning to provide support for (1) the theorized inter-relations

between meta-awareness, disidentification from internal experience, and reduced reactivity to

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

documents key limitations of extant self-report scales of decentering, a growing number of

tools to measure and study meta-awareness, and initial but fewer tools to measure and study

disidentification from internal experience as well as reduced reactivity to thought content.

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

metacognitive processes to therapeutically target in order to reduce psychological

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

training; (3) To develop novel experimental therapeutic technologies based on effective

Running Head: DECENTERING METHODS AND INSIGHTS 14

micro-interventions such as via Sequential Multiple Assignment Randomized Trial (SMART)

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

meta-awareness of biased attentional processing; e.g., Bernstein & Zvielli). In summary, we

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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