Abstract
Mindfulness has been defined as the concentration of non-judgmental attention along with accepting the experience occurring in the present. Previous studies have shown that mindfulness decreases pregnant women’s anxiety. This study examined the relationship between mindfulness facets, cognitive flexibility components, and death anxiety in third-trimester pregnant women in Kerman in 2021. Two hundred fifty-six pregnant women completed the FFMQ, CFI, and DASS questionnaires. Path analysis of responses showed that describing, non-judging, and non-reactivity facets of mindfulness, positively predict alternative component of cognitive flexibility and describing facet of mindfulness positively predicts control component of cognitive flexibility. In this analysis, only the direct effect of describing facet of mindfulness on death anxiety was significant and its indirect effect was applied by control component of cognitive flexibility. Thus, these findings supported previous studies on the importance of mindfulness in pregnant women to increase cognitive flexibility and thus reduce their death anxiety. Therefore, if mindfulness training for pregnant women is implemented by emphasizing the importance of describing their experiences and increasing their control over their own situation, significant results can be expected in this area.
Similar content being viewed by others
Data and material availability
Available on demand.
Code availability
Not applicable for that section.
References
Agnoli, S., Vanucci, M., Pelagatti, C., & Corazza, G. E. (2018). Exploring the link between mind wandering, mindfulness, and creativity: A multidimensional approach. Creativity Research Journal, 30(1), 41–53.
Arslan, G. (2021). Understanding wellbeing and death obsession of young adults in the context of Coronavirus experiences: Mitigating the effect of mindful awareness. Death Studies. https://doi.org/10.1080/07481187.2020.1871122
Baer, R. A., Smith, G. T., Hopkins, J., Krietemeyer, J., & Toney, L. (2006). Using self-report assessment methods to explore facets of mindfulness. Assessment, 13(1), 27–45.
Baer, R. A., Smith, G. T., Lykins, E., Button, D., Krietemeyer, J., Sauer, S., Walsh, E., Duggan, D., & Williams, J. M. G. (2008). Construct validity of the five facet mindfulness questionnaire in meditating and nonmeditating samples. Assessment, 15(3), 329–342.
Bambo, S. C., & Mashegoane, S. (2021). Death obsession’s potential mediational role in the relation between pregnancy-related anxiety and prenatal obsessive-compulsive disorder. South African Journal of Psychology, 51(3), 369–382.
Bayati, A., Abbasi, P., Ziapour, A., Parvane, E., & Dehghan, F. (2017). Effectiveness of acceptance and commitment therapy on death anxiety and death obsession in the elderly. Middle East Journal of Family Medicine, 15, 122–128.
Cash, M., & Whittingham, K. (2010). What facets of mindfulness contribute to psychological well-being and depressive, anxious, and stress-related symptomatology? Mindfulness, 1(3), 177–182.
Chan, K. P. (2016). Perceptions and experiences of pregnant Chinese women in Hong Kong on prenatal meditation: A qualitative study. Journal of Nursing Education and Practice, 6(3), 135–146.
Chan, C. Y., Lee, A. M., Lam, S. K., Lee, C. P., Leung, K. Y., Koh, Y. W., & Tang, C. S. K. (2013). Antenatal anxiety in the first trimester: Risk factors and effects on anxiety and depression in the third trimester and 6-week postpartum. Open Journal of Psychiatry, 3, 301–310.
Damirchi, E. S., Mojarrad, A., Pireinaladin, S., & Grjibovski, A. M. (2020). The role of self-talk in predicting death anxiety, obsessive-compulsive disorder, and coping strategies in the face of coronavirus disease (COVID-19). Iranian Journal of Psychiatry, 15(3), 182.
Dennis, J. P., & Vander Wal, J. S. (2010). The cognitive flexibility inventory: Instrument development and estimates of reliability and validity. Cognitive Therapy and Research, 34(3), 241–253.
Desrosiers, A., Klemanski, D. H., & Nolen-Hoeksema, S. (2013). Mapping mindfulness facets onto dimensions of anxiety and depression. Behavior Therapy, 44(3), 373–384.
Dorji, N., & Lapierre, S. (2021). Perception of death and preference for end-of-life care among Asian Buddhists living in Montreal, Canada. Death Studies, 1–13.
Duncan, L. G., & Bardacke, N. (2010). Mindfulness-based childbirth and parenting education: Promoting family mindfulness during the perinatal period. Journal of Child and Family Studies, 19(2), 190–202.
Farahi, S., & Khalatbari, J. (2019). Effectiveness of acceptance and commitment therapy on the life expectancy, resilience and death anxiety in women with cancer. International Journal of Applied Behavioral Sciences, 6(3), 9–19.
Ghanbarpoor Ganjari, M., Khanmohammadzadeh, Z., Nobakht, H., & Eslami Kenarsari, H. (2020). The role of cognitive emotion regulation strategies, cognitive flexibility, and distress tolerance in death anxiety among women with hypertension: A descriptive correlation study. Jundishapur Journal of Chronic Disease Care (In Press), 9(4).
Gilbert, D., & Waltz, J. (2010). Mindfulness and Health Behaviors. Mindfulness, 1(4), 227–234.
Glomb, T. M., Duffy, M. K., Bono, J. E., & Yang, T. (2011). Mindfulness at work. Research in Personnel and Human Resources Management, 30, 115–157.
Grevenstein, D., & Bluemke, M. (2016). Who’s afraid of death and terrorists? Investigating moderating effects of sense of coherence, mindfulness, neuroticism, and meaning in life on mortality salience. Journal of Articles in Support of the Null Hypothesis, 13(1), 25–36.
Han, D. H., Park, H. W., Kee, B. S., Na, C., Na, D.-H.E., & Zaichkowsky, L. (2011). Performance enhancement with low stress and anxiety modulated by cognitive flexibility. Psychiatry Investigation, 8(3), 221.
Hawley, L. L., Rogojanski, J., Vorstenbosch, V., Quilty, L. C., Laposa, J. M., & Rector, N. A. (2017). The structure, correlates, and treatment related changes of mindfulness facets across the anxiety disorders and obsessive compulsive disorder. Journal of Anxiety Disorders, 49, 65–75.
Hoelterhoff, M. (2015). A theoretical exploration of death anxiety. Journal of Applied Psychology and Social Science, 1(2), 1–17.
Hulsbosch, L. P., Boekhorst, M. G., Potharst, E. S., Pop, V. J., & Nyklíček, I. (2021). Trait mindfulness during pregnancy and perception of childbirth. Archives of Women’s Mental Health, 24(2), 281–292.
Iverach, L., Menzies, R. G., & Menzies, R. E. (2014). Death anxiety and its role in psychopathology: Reviewing the status of a transdiagnostic construct. Clinical Psychology Review, 34(7), 580–593.
Johnco, C., Wuthrich, V. M., & Rapee, R. M. (2014). Reliability and validity of two self-report measures of cognitive flexibility. Psychological Assessment, 26(4), 1381.
Kabat-Zinn, J. (2009). Wherever you go, there you are: Mindfulness meditation in everyday life. Hachette Books.
Kantrowitz-Gordon, I. (2018). Factor structure and external validity of the five facet mindfulness questionnaire in pregnancy. Mindfulness, 9(1), 243–257.
Kearns, N. T., Villarreal, D., Cloutier, R. M., Baxley, C., Carey, C., & Blumenthal, H. (2018). Perceived control of anxiety as a moderator in the relationship between anxiety sensitivity and problematic alcohol use among adolescents. Journal of Adolescence, 63, 41–50.
Kohandani, M., & Abolmaali Alhosseini, K. (2017). Factor structure and psychometric properties of Persian version of cognitive flexibility of Dennis, Vander Wal and Jillon. Psychological Models and Mrthod, 3, 53–70.
Lee, J. K., & Orsillo, S. M. (2014). Investigating cognitive flexibility as a potential mechanism of mindfulness in generalized anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 45(1), 208–216.
Lotfifar, B., Ghadampour, E., & Bagheri, N. (2021). Comparative effectiveness of psychotherapy approaches on Death Anxiety in Multiple Sclerosis Patients. A pilot randomized controlled trial. Multiple Sclerosis and Related Disorders, 51, 102914.
Lu, F., Xu, Y., Yu, Y., Peng, L., Wu, T., Wang, T., Liu, B., Xie, J., Xu, S., & Li, M. (2019). Moderating effect of mindfulness on the relationships between perceived stress and mental health outcomes among Chinese intensive care nurses. Frontiers in Psychiatry, 10, 260.
Manze, M. G., Watnick, D., & Romero, D. (2019). A qualitative assessment of perspectives on getting pregnant: The Social Position and Family Formation study. Reproductive Health, 16(1), 1–9.
Michaud, A. (2020). Attitudes toward death: How buddhist teachings help a person cope with death anxiety and accept death.
Mirabzadeh, A., Dolatian, M., Forouzan, A. S., Sajjadi, H., Majd, H. A., & Mahmoodi, Z. (2013). Path analysis associations between perceived social support, stressful life events and other psychosocial risk factors during pregnancy and preterm delivery. Iranian Red Crescent Medical Journal, 15(6), 507.
Mohamed, S. M., Elsharkawy, N. B., & Awad, M. H. (2017). Mindfulness based intervention program on anxiety and depressive symptoms among pregnant women. American Journal of Nursing, 6(3), 232–239.
Moon, H. G. (2019). Mindfulness of death as a tool for mortality salience induction with reference to terror management theory. Religions, 10(6), 353.
Moore, B. A. (2013). Propensity for experiencing flow: The roles of cognitive flexibility and mindfulness. The Humanistic Psychologist, 41(4), 319.
Nyatanga, B., & de Vocht, H. (2006). Towards a definition of death anxiety. International Journal of Palliative Nursing, 12(9), 410–413.
Park, Y. C. (2016). Effect of meditation on death-thought accessibility and worldview defense in response to mortality salience. The University of Colorado Colorado Springs.
Park, O., Lee, Y.-K., Kim, Y., & Smith-Stoner, M. (2016). The effect of insight based death meditation on death anxiety and qualify of life. International Journal of Existential Positive Psychology, 6(1), 10.
Parsons, E. M., Luebbe, A. M., & Clerkin, E. M. (2017). Testing the relationship between social anxiety schemas, mindfulness facets, and state and trait social anxiety symptoms. Mindfulness, 8(6), 1634–1643.
Rice, F. K. (2021). Mindfulness-based interventions for prenatal stress, anxiety, and depression.
Romanis, E. C., Begović, D., Brazier, M. R., & Mullock, A. K. (2021). Reviewing the womb. Journal of Medical Ethics, 47(12), 820–829.
Royal, K. D., & Elahi, F. (2011). Psychometric properties of the Death Anxiety Scale (DAS) among terminally ill cancer patients. Journal of Psychosocial Oncology, 29(4), 359–371.
Schultz, D. M., & Arnau, R. C. (2019). Effects of a brief mindfulness induction on death-related anxiety. OMEGA-Journal of Death and Dying, 79(3), 313–335.
Shapiro, S. L., & Walsh, R. (2003). An analysis of recent meditation research and suggestions for future directions. The Humanistic Psychologist, 31(2–3), 86–114.
Shapiro, S. L., Carlson, L. E., Astin, J. A., & Freedman, B. (2006). Mechanisms of mindfulness. Journal of Clinical Psychology, 62(3), 373–386.
Sheykholeslami, A., & Samadifard, H. (2018). Death anxiety in the elderly: The role of cognitive failures, flexibility and distortion.
Sinnott, J., Hilton, S., Wood, M., & Douglas, D. (2020). Relating flow, mindfulness, cognitive flexibility, and postformal thought: Two studies. Journal of Adult Development, 27(1), 1–11.
Sjögren, B. (1997). Reasons for anxiety about childbirth in 100 pregnant women. Journal of Psychosomatic Obstetrics & Gynecology, 18(4), 266–272.
Soleimani, M. A., Pahlevan Sharif, S., Yaghoobzadeh, A., Allen, K.-A., & Sharif Nia, H. (2017). An examination of psychometric characteristics and factor structure of death anxiety scale within a sample of Iranian patients with heart disease. International Journal of Epidemiologic Research, 4(4), 260–266.
Tamannaeifar, S., Asgharnejad Farid, A., Mirzaee, M., & Soleimani, M. (2016). Psychometric Properties of Five Factor Mindfulness Questionnaire. Developmental Pschology: Iranian Psychologists, 12(47), 321–329.
Templer, D. I. (1970). The construction and validation of a death anxiety scale. The Journal of General Psychology, 82(2), 165–177.
Testoni, I., Ronconi, L., Cupit, I. N., Nodari, E., Bormolini, G., Ghinassi, A., Messeri, D., Cordioli, C., & Zamperini, A. (2019). The effect of death education on fear of death amongst Italian adolescents: A nonrandomized controlled study. Death Studies.
Van den Heuvel, M., Johannes, M., Henrichs, J., & Van den Bergh, B. (2015). Maternal mindfulness during pregnancy and infant socio-emotional development and temperament: The mediating role of maternal anxiety. Early Human Development, 91(2), 103–108.
Wen, X., Zhang, Q., Liu, X., Du, J., & Xu, W. (2021). Momentary and longitudinal relationships of mindfulness to stress and anxiety among Chinese elementary school students: Mediations of cognitive flexibility, self-awareness, and social environment. Journal of Affective Disorders, 293, 197–204.
Yin, F., He, Y., He, Y., Shen, H., & Ip, K. (2020). A comparative study of death anxiety and death attitudes in Han and Tibetan ethnic groups. Death Studies. https://doi.org/10.1080/07481187.2020.1802791
Zemestani, M., & Fazeli, N. Z. (2020). Effectiveness of mindfulness-based cognitive therapy for comorbid depression and anxiety in pregnancy: A randomized controlled trial. Archives of Women’s Mental Health, 23(2), 207–214.
Zhou, X., Lei, Q., Marley, S. C., & Chen, J. (2009). Existential function of babies: Babies as a buffer of death-related anxiety. Asian Journal of Social Psychology, 12(1), 40–46.
Zou, Y., Li, P., Hofmann, S. G., & Liu, X. (2020). The mediating role of non-reactivity to mindfulness training and cognitive flexibility: A randomized controlled trial. Frontiers in Psychology, 11, 1053.
Zuccala, M., Menzies, R. E., Hunt, C. J., & Abbott, M. J. (2019). A systematic review of the psychometric properties of death anxiety self-report measures. Death Studies, 1–23.
Acknowledgements
The authors sincerely thank all pregnant women who participated in this study.
Funding
No funding was provided for the completion of the study.
Author information
Authors and Affiliations
Contributions
We confirm that the order of authors listed in the manuscript has been approved by all of us.
Corresponding author
Ethics declarations
Conflict of interest
The authors have no conflicts of interest to disclose.
Ethical approval
Ethics was approved by the Psychology Department of Shahid Bahonar University of Kerman and received the Code of Ethics (E. A. 97. 11. 13. 01).
Consent to participate
All participants answered the questionnaires with full satisfaction.
Consent for publication
All authors read and approved the final manuscript.
Additional information
Publisher's Note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Askarizadeh, G., Poormirzaei, M. & Bagheri, M. Mindfulness Facets and Death Anxiety: The Role of Cognitive Flexibility Components. Psychol Stud 67, 208–217 (2022). https://doi.org/10.1007/s12646-022-00655-w
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12646-022-00655-w