Dispositional Mindfulness Mediates the Relationship Between Sensory-Processing Sensitivity and Trait Anxiety,Well-Being,and Psychosomatic Symptoms

Abstract

Recent studies have suggested that sensory-processing sensitivity correlates to poor psychological and physical health. However, it remains unclear how this occurs. Sensory-processing sensitivity can be understood as sensitivity to sensations without the presence of intentional awareness and a nonreactive attitude, which are the components of mindfulness. We tested the hypothesis that dispositional mindfulness mediates the relationship between sensory-processing sensitivity and trait anxiety, well-being and psychosomatic symptoms. We analyzed data from 563 participating young adults living in Japan. Multiple mediation analysis showed that the four facets (nonreactivity, nonjudging, describing, and acting with awareness) of mindfulness partially mediated the effects of sub-factors of sensory-processing sensitivity (low sensory threshold and ease of excitation) on trait anxiety. Nonreactivity, describing, and acting with awareness partially mediated the effect of low sensory threshold on well-being and fully mediated the effect of ease of excitation. Nonjudging and acting with awareness partially mediated the effects of low sensory threshold and ease of excitation on psychosomatic symptoms. As a whole, the mediation hypotheses were supported, and it was determined that the improvement of dispositional mindfulness may prove effective for the psychological and physical problems of people with high sensory-processing sensitivity.

Keywords

Dispositional mindfulness sensory-processing sensitivity trait anxiety well-being psychosomatic symptom mediation

Introduction

Sensory-processing sensitivity (SPS) can lead to poor psychological and physical health. Aron and Aron (1997) described high SPS as an individual difference characteristic according to which people are particularly sensitive to subtle stimuli and easily overstimulated. SPS is a relatively new concept, with a biological basis (Aron, Aron, & Jagiellowicz, 2012), and it must be distinguished from introversion and neuroticism (Aron & Aron, 1997). People with high SPS tend to be more anxious and suffer more from depression (Liss, Mailloux, & Erchull, 2008; Liss, Timmel, Baxley, & Killingsworth, 2005), show low well-being (Booth, Standage, & Fox, 2015; Sobocko & Zelenski, 2015), and have more stress-related physical symptoms (Benham, 2006). Although SPS has positive aspects (e.g., aesthetic sensitivity (AES) to internal and external objects), it also can reduce psychological and physical health. SPS is thought to precede low psychological and physical health, because it is tentatively associated with a variation of genes for the serotonin (Licht, Mortensen, & Knudsen, 2011) and dopamine (Chen et al., 2011) systems, and the individual differences that appear similar to SPS can be observed in early childhood (Kagan, Reznick, & Snidman, 1988; Thomas & Chess, 1986).

It is unknown by what mechanism SPS leads to low psychological and physical health, although many studies have examined the direct relationship between them. It is yet to be determined what psychological variable that can be targeted in intervention mediates the relationship between SPS and psychological and physical health, because SPS itself is an inherent factor and difficult to change. Furthermore, such an examination would be highly meaningful, given that people with high SPS may have greater treatment response to psychological intervention than those with low SPS (Pluess & Boniwell, 2015).

Mindfulness is defined as “the awareness that emerges through paying attention on purpose, in the present moment, and nonjudgmentally to the unfolding of experience moment by moment” (Kabat-Zinn, 2003). Dispositional mindfulness is correlated positively with well-being and negatively with anxiety, depression, and psychosomatic symptoms (Brown & Ryan, 2003). Furthermore, recent systematic review has shown that greater self-reported change in mindfulness mediated better clinical outcomes in standard mindfulness-based intervention (Alsubaie et al., 2017). SPS can be expected to lead to low dispositional mindfulness. It appears to be thought that high SPS correlates with high dispositional mindfulness, because both tendencies have the characteristic of sensitivity to sensations. However, people with greater dispositional mindfulness are paying attention to sensations “on purpose” and “nonjudgmentally.” In contrast, people with high SPS can be overwhelmed by physical sensations rather than being intentionally aware of them. It has been demonstrated that they show little mindful attention and awareness (Bakker & Moulding, 2012). Furthermore, they may often react to their sensations with a judgmental attitude. Aron et al. (2012) argued that they tend to exhibit a “depth of processing,” that is, “deeper processing of this sensory information, relating it to the past and projecting its consequences into the future” (Aron et al., 2012). This means that they have the tendency to judge their own experiences. It has also been shown that SPS is negatively correlated with acceptance (Bakker & Moulding, 2012), which is an important skill in mindfulness training (Lindsay & Creswell, 2017). In standard mindfulness-based interventions such as mindfulness-based stress reduction (MBSR; Kabat-Zinn, 1990) and mindfulness-based cognitive therapy (MBCT; Segal, Williams, & Teasdale, 2002), participants intentionally pay attention to a part of their body without reacting to or judging the sensation. Although MBCT emphasizes detachment from cognition, its point of intensive training of attention to raw sensations is identical to MBSR. Such training is considered to cultivate the two capacities of monitoring and acceptance skills, which are potential mechanism variables in mindfulness training (Lindsay & Creswell, 2017).

There is another important relationship between SPS and mindfulness in the form of interceptive awareness. Interception is the perception of sensations from inside the body and it includes the perception of physical sensations related to the functions of internal organs such as the heart beat and the autonomic nervous system activity related to emotions (Craig, 2002; Price & Hooven, 2018). The awareness of interception is acutely related to emotional experience and its regulation (Khalsa & Lapidus, 2016). It is indicated that awareness without nonreactive attitude may amplify negative feelings and symptoms (Lindsay & Creswell, 2017), and this might be the case in people with high SPS because they are aware of their interception and tend to react to it. On the other hand, training in awareness with nonreactive attitude is intensively provided in mindfulness interventions, which in turn may lead to reduced distress and improved well-being.

Based on the above review, we hypothesized that dispositional mindfulness mediates the relationship between SPS and three variables that have been shown to be correlated with both dispositional mindfulness and SPS: trait anxiety, well-being, and psychosomatic symptoms. In this study, psychosomatic symptoms signify bodily distress arising from perceptions of bodily dysfunction. We aimed to test these hypotheses pertaining to mediation on young adults living in Japan. We targeted young adults because numerous previous studies have investigated the population, primarily students in universities or colleges, and we will compare our results with the findings of those studies. We used two subscales of the Japanese version of the Highly Sensitive Person Scale (HSPS-J19; Takahashi, 2016; original version (27-item), Aron & Aron, 1997), which assesses the negative aspects of SPS, because our hypotheses refer to such aspect. We also used four facets (nonreactivity, nonjudging, describing, and acting with awareness) of the Five Facet Mindfulness Questionnaire (FFMQ; Japanese version, Sugiura, Sato, Ito, & Murakami, 2012; original version, Baer, Smith, Hopkins, Krietemeyer, & Toney, 2006). We did not include the observing facet in our model, because it is known not to have an adaptive function for psychological health in nonmeditating samples (Baer et al., 2008; de Bruin, Topper, Muskens, Bögels, & Kamphuis, 2012). Each facet may have a different mediation effect, so we examined the unique mediation effects of each facet in addition to the total mediation effect of the facets.

Methods

Participants and procedure

The survey was conducted among students and workers in Japan. We distributed a paper-based questionnaire or pieces of paper on which the URL for our online questionnaire was written to students at the end of lectures at the University of Tokyo and Rissho University. Recruitment was also done by convenience sampling among the acquaintances of the first author and by word of mouth. A total of 635 participants completed the questionnaire, either on the online or in the paper form. The participants were informed that participation was voluntary, and they were not paid for participation. We excluded nine participants who were 30 years old or older and one participant who was living abroad, because the target population was young adults living in Japan. There were 62 participants who had missing values, and so data from 563 participants (mean 21.1 years old, SD = 1.95; 283 males, 280 females; 488 students, 24 workers, 3 others, and 48 no response) were analyzed. This research was approved by the Ethics Review Committee of The University of Tokyo.

Measures

The Highly Sensitive Person Scale

The HSPS-J19 is a 19-item measure of SPS, each item rated on a seven-point scale (1 to 7). The scale includes three subscales: low sensory threshold (LST; items 5, 7, 9, 16, 19, 23, and 25, which are found in the original HSPS of Aron & Aron, 1997; Cronbach’s α = .78 in Takahashi, 2016), ease of excitation (EOE; items 1, 3, 4, 13, 14, 21, 26, and 27; α = .71), and AES (items 8, 10, 12, and 22; α = .57). Smolewska, McCabe, and Woody (2006) concluded that LST is related to unpleasant sensory arousal to external stimuli (e.g., “Are you bothered by intense stimuli, like loud noises or chaotic scenes?”). EOE is related to becoming mentally overwhelmed by external and internal demands (e.g., “Do you startle easily?”). AES is related to aesthetic awareness (e.g., “Do you notice and enjoy delicate or fine scents, tastes, sounds, works of art?”). High scores mean high levels of SPS. The Japanese version (Takahashi, 2016) showed adequate internal consistency and validity, except for AES. We used the two subscales LST and EOE, because our hypotheses refer to the negative aspects of SPS, whereas AES is considered to only reflect positive aspects. In the sample of this study, Cronbach’s αs were .79 (LST) and .73 (EOE).

The Five Facet Mindfulness Questionnaire

The Japanese version of the FFMQ is a 39-item measure of five facets of mindfulness, each rated on a five-point scale (1 to 5). We used the subscales of the four facets, with the exception of the observing facet, as discussed above. The four facets are nonreactivity (seven items, e.g., “I perceive my feelings and emotions without having to react to them,” α = .67, in Sugiura et al., 2012), nonjudging (eight items, e.g., “I criticize myself for having irrational or inappropriate emotions (a reverse item),” α = .84), describing (8 items, e.g., “I’m good at finding the words to describe my feelings,” α = .85), and acting with awareness (8 items, e.g., “I find it difficult to stay focused on what’s happening in the present” (a reverse item), α = .80). High scores reflect high levels of dispositional mindfulness. The Japanese version (Sugiura et al., 2012) showed adequate internal consistency and validity. In the sample of this study, Cronbach’s αs were .69 (nonreactivity), .86 (nonjudging), .85 (describing), and .80 (acting with awareness).

The State–Trait Anxiety Inventory

The Japanese version of the State–Trait Anxiety Inventory (STAI; Shimizu & Imae, 1981; original version, Spielberger, Gorsuch, & Lushene, 1970) is a measure of state and trait anxiety. We used a sub-inventory of 20 items measuring trait anxiety (STAI-T), each rated on a four-point scale (1 to 4). A high total score means a high level of trait anxiety. The Japanese version (Shimizu & Imae, 1981) had adequate reliability (α = .85) and validity. In the sample of this study, Cronbach’s α for the STAI-T was .86.

The WHO-5

The Japanese version of the 5-Item World Health Organization Well-Being Index (WHO-5; Awata et al., 2007) is a five-item measure of well-being, each rated on a six-point scale (0 to 5). The WHO-5 asks how long participants have been feeling well over the last two weeks. The items are, for example, (over the last two weeks) “I have felt cheerful and in good spirits” and “I have felt calm and relaxed.” A high total score means a high level of well-being. The Japanese version had adequate reliability (α = .89) and validity. In the sample of this study, Cronbach’s α for the WHO-5 was .78.

The Hopkins Symptom Checklist

The Japanese version of the Hopkins Symptom Checklist (HSCL; Nakano & Kitamura, 2001; original version, Derogatis, Lipman, Rickels, Uhlenhuth, & Covi, 1974) is a self-reported measure of symptoms commonly observed among psychiatric outpatients. We used 14 items measuring psychosomatic symptoms, each rated on a four-point scale (1 to 4). The psychosomatic symptom subscale reflects distress arising from perceptions of bodily dysfunction (circulatory, digestive, respiratory, and other systems with marked autonomic medication). The HSCL asks how frequently symptoms arose over the last week. The items are, for example, “headaches” and “faintness or dizziness.” A high total score means a high frequency and many kinds of psychosomatic symptoms. The Japanese version (Nakano & Kitamura, 2001) had adequate reliability (α = .83) and validity. In the sample of this study, Cronbach’s α for the HSCL was .85.

All the scores for each (sub)scale were calculated by dividing the total score by the numbers of items. The distributed questionnaire included the openness subscale of NEO-five-factor inventory (12 items; Costa & McCrae, 1992), Depression and Anxiety Mood Scale (DAMS, nine items; Fukui, 1997), and a brief negative mood induction using a situation image method (Koda & Ito, 2009), which were measured for another purpose, reported in Takahashi et al. (2015). The order of each scale and manipulation in the questionnaire was DAMS (baseline), FFMQ, HSPS, STAI-T, mood induction manipulation, DAMS (post-mood induction), HSCL (psychosomatic symptoms), NEO-five-factor inventory (openness scale), and WHO-5.

Data analyses

We tested our hypothesis about the mediating effect of dispositional mindfulness on the relationship between SPS and trait anxiety, well-being, and psychosomatic symptoms. First, we calculated Pearson’s product moment correlations and partial correlations, controlled by gender and age, between dispositional mindfulness, SPS, trait anxiety, well-being, and psychosomatic symptoms. Second, multiple mediation analyses were conducted to evaluate the mediation effects of four facets (nonreactivity, nonjudging, describing, and acting with awareness) of dispositional mindfulness on the relationship between LST and EOE (negative aspects of SPS) and trait anxiety, well-being, and psychosomatic symptoms by using Preacher and Hayes's (2004) approach. To show the 95% confidence interval for the indirect effects, a bias-corrected bootstrapping procedure was carried out with 2000 resamples. All analyses were carried out by SPSS 24, and the mediation analyses were done using the SPSS macro PROCESS (Hayes, 2013).

Results

Simple and partial correlation between SPS, dispositional mindfulness, and psychological and physical health

The zero-order and partial correlation coefficients among SPS, dispositional mindfulness, trait anxiety, well-being, psychosomatic symptoms, and descriptive data (means and SDs) are provided in Table 1 to show the basic characteristics of the variables. Partial correlation coefficients were controlled by age and gender, because these were considered to be correlated with certain variables. The results showed no large differences between zero-order correlations and partial correlations. As expected, LST and EOE were negatively correlated with the four facets (nonreactivity, nonjudging, describing, and acting with awareness) chosen from the FFMQ. Furthermore, LST and EOE were positively correlated with STAI-T and HSCL and negatively with WHO-5. The four facets of FFMQ were correlated negatively with STAI-T and HSCL and positively with WHO-5.

Table 1.

Means, SDs, and zero-order and partial correlation coefficients controlled by age and gender.

	LST	EOE	Nonreact	Nonjudge	Describe	Act aware	STAI-T	WHO-5	HSCL
HSPS LST		.62**	−.25**	−.25**	−.25**	−.36**	.51**	−.25**	.23**
HSPS EOE	.63**		−.33**	−.35**	−.32**	−.38**	.62**	−.21**	.28**
FFMQ nonreact	−.27**	−.34**		.09*	.22**	.09*	−.48**	.24**	−.08
FFMQ nonjudge	−.24**	−.35**	.09*		.10*	.30**	−.34**	.09*	−.23**
FFMQ describe	−.26**	−.33**	.23**	.11**		.24**	−.37**	.29**	−.09*
FFMQ act aware	−.34**	−.37**	.08*	.29**	.23**		−.42**	.25**	−.23**
STAI-T	.51**	.62**	−.49**	−.35**	−.38**	−.41**		−.50**	.43**
WHO-5	−.25**	−.21**	.24**	.09*	.29**	.25**	−.50**		−.25**
HSCL	.24**	.29**	−.10*	−.23**	−.10*	−.22**	.43**	−.25**
Age	−.02	−.04	.06	.10*	.17**	−.01	−.10*	.03	−.08
Gender	.17**	.16**	−.15**	.00	−.07	.06	.07	.00	.11**
Mean	4.38	4.44	2.88	2.97	2.87	3.17	2.43	2.62	1.54
SD	1.07	0.90	0.58	0.77	0.71	0.65	0.49	0.93	0.49

Note: The correlation coefficients below the diagonal blank line are zero order correlations and those above the line are partial correlation coefficients controlled by age and gender. Gender was a dummy variable, coded male = 0, female = 1. HSPS: Highly Sensitive Person Scale; LST: low sensory threshold; EOE: ease of excitation; FFMQ: Five Facet Mindfulness Questionnaire; STAI: State–Trait Anxiety Inventory; WHO-5: 5-Item World Health Organization Well-Being Index; HSCL: Hopkins symptom checklist psychosomatic symptom subscale.

*p < .05; **p < .01.

Multiple mediation model of dispositional mindfulness in relation to SPS and psychological and physical health

Our multiple mediation models are given in Figure 1. We conducted multiple mediation analyses for these six models (combinations of the two independent variables LST and EOE and the three dependent variables STAI-T, WHO-5, and HSCL). We then found the 95% confidence interval for the indirect effects of the subscales of HSPS on the dependent variables through facets of the FFMQ (Table 2). Age and gender were controlled in all mediation analyses. All variables were standardized to show standardized coefficients before multiple mediation analyses.

Figure 1.

Mediation models of the relation between LST and EOE of HSPS and STAI-T, WHO-5, and HSCL psychosomatic symptom in four facets of FFMQ. In total, six models, the combinations of two independent variables of HSPS and three dependent variables about psychological problems, were tested; c means the total effect of the independent variable on the dependent variable, and cʹ means the direct effect of the independent variable, controlling for the effects of mediators.

Table 2.

Direct and indirect effects of SPS on trait-anxiety, well-being, and psychosomatic symptom in mindfulness controlled by age and gender.

					Indirect effect		Total effect	Direct effect	Percent mediation
DV	IV	Mediator	a	b	ab	95% CI	c	c′	Percent mediation
STAI-T	LST	Nonreact	−.254***	−.350***	.089	(.056, .129)			.174
		Nonjudge	−.251***	−.170***	.043	(.021, .067)			.083
		Describe	−.251***	−.164***	.041	(.022, .068)			.080
		Act aware	−.365***	−.198***	.072	(.046, .108)			.141
		Sum of mediators			.245	(.194, .302)	.511***	.267***	.479
	EOE	Nonreact	−.327***	−.311***	.102	(.070, .140)			.164
		Nonjudge	−.357***	−.118***	.042	(.019, .068)			.068
		Describe	−.321***	−.130***	.042	(.019, .071)			.067
		Act aware	−.385***	−.182***	.070	(.043, .103)			.113
		Sum of mediators			.256	(.203, .311)	.620***	.365***	.412
WHO-5	LST	Nonreact	−.254***	.163***	−.042	(−.072, −.020)			.161
		Nonjudge	−.251***	−.016	.004	(−.018, .029)			−.016
		Describe	−.251***	.191***	−.048	(−.077, −.024)			.186
		Act aware	−.365***	.151***	−.055	(−.096, −.022)			.215
		Sum of mediators			−.141	(−.196, −.094)	−.257***	−.117**	.546
	EOE	Nonreact	−.327***	.179***	−.058	(−.096, −.031)			.271
		Nonjudge	−.357***	−.006	.002	(−.028, .038)			−.011
		Describe	−.321***	.201***	−.065	(−.101, −.034)			.300
		Act aware	−.385***	.176***	−.068	(−.111, −.032)			.315
		Sum of mediators			−.188	(−.253, −.124)	−.215***	−.027	.875
HSCL	LST	Nonreact	−.254***	−.018	.005	(−.018, .030)			.020
		Nonjudge	−.251***	−.150***	.038	(.016, .068)			.162
		Describe	−.251***	−.001	.000	(−.022, .026)			.001
		Act aware	−.365***	−.129**	.047	(.015, .091)			.203
		Sum of mediators			.090	(.046, .138)	.232***	.142**	.386
	EOE	Nonreact	−.327***	.003	−.001	(−.031, .032)			−.003
		Nonjudge	−.357***	−.122**	.043	(.015, .081)			.155
		Describe	−.321***	.017	−.006	(−.038, .021)			−.020
		Act aware	−.385***	−.120**	.046	(.016, .087)			.165
		Sum of mediators			.083	(.033, .138)	.280***	.197***	.297

Note: Percent mediation means the ratio of indirect effect to the total effect (ab/c). DV: dependent variable; IV: independent variable; CI: confidence interval; ab: the indirect effect, that is, the product of the path a from independent variable to the mediator and path b from the mediator to dependent variable (see Figure 1); STAI: State-Trait Anxiety Inventory; WHO-5: 5-Item World Health Organization Well-Being Index; HSCL: Hopkins symptom checklist psychosomatic symptom subscale; LST: low sensory threshold (HSPS); EOE: ease of excitation (HSPS); HSPS: Highly Sensitive Person Scale. *p < .05; **p < .01; ***p < .001.

The results showed that all indirect effects through the FFMQ facets were significant in the mediation model of LST and EOE together with STAI-T, because the 95% confidence interval did not contain zero. The direct effects of LST and EOE remained significant, meaning a partial mediation model. It was shown that the mediators could account for .479 and .412 of the total effects of LST and EOE, respectively, on STAI-T (percent mediation). In regard to WHO-5, indirect effects through nonreactivity, describing, and acting with awareness were significant in the mediation model of LST and EOE together with WHO-5. The direct effect of LST remained significant, whereas the direct effect of EOE was nonsignificant, meaning a complete mediation model. The mediators accounted for .546 and .875 of the total effects of LST and EOE, respectively, on WHO-5. In relation to HSCL, the indirect effects through nonjudging and acting with awareness were significant in the mediation model of LST and EOE together with HSCL somatic symptoms. The direct effects of both LST and EOE were significant, meaning partial mediation model. The mediators accounted for .386 and .297 of the total effects of LST and EOE, respectively, on HSCL.

Discussion

General discussion

This study tested the hypotheses that dispositional mindfulness mediates the relationship between the negative aspects of SPS and trait anxiety, well-being, and psychosomatic symptoms. The hypotheses were supported as a whole, because it was shown that all models were partial or complete mediation models. SPS is thought to lead to low dispositional mindfulness, which in turn leads to high trait anxiety, low well-being, and many psychosomatic symptoms.

In the mediation model of LST and EOE together with trait anxiety, the indirect effects through all facets of FFMQ were significant, and roughly half of the total effect was accounted for by the sum of indirect effects. It is consistent with this observation that both LST and EOE are related to a tendency to anxiety (Liss et al., 2005, 2008), and the dispositional mindfulness measured by FFMQ showed partial mediation for trait anxiety in MBSR program for anxiety disorders (Vøllestad, Sivertsen, & Nielsen, 2011).

In the model of LST and EOE together with well-being, the indirect effects through nonreactivity, describing, and acting with awareness were significant. The model of LST was partial mediation, and half of the total effect was accounted for by the sum of indirect effects, whereas the model of EOE was complete mediation, and most of the total effect was accounted for. EOE is related to a higher arousal than LST, as seen in the subscale contents, and EOE showed a stronger positive correlation with anxiety than LST (Ahadi & Basharpoor, 2010; Liss et al., 2008). Therefore, it is possible that high arousal caused by SPS deprives people with high SPS of room for awareness and describing experience with a nonreactive attitude, which in turn leads to low well-being. Furthermore, the difference between the results for LST and EOE is consistent with the observation that dispositional mindfulness is negatively correlated with neuroticism (Giluk, 2009), and only EOE significantly predicted neuroticism in relation to entering all subscales of HSPS into multiple regression model (Ahadi & Basharpoor, 2010). In addition, a study evinced that dispositional mindfulness mediates the relationship between neuroticism and psychological well-being (Iani, Lauriola, Cafaro, & Didonna, 2017). It may be that dispositional mindfulness has a greater effect on the neurotic aspects of SPS that lead to poor mental health.

In the model of LST and EOE together with psychosomatic symptoms, the direct effects through nonjudging and acting with awareness were significant, and roughly 30%–40% of the total effect was accounted for by the sum of indirect effects. In other words, high SPS may cause people to lose the ability to be intentionally aware of body sensation and judge it, which in turn leads to worse psychosomatic symptoms. Recently, it has been shown that perseverative cognition leads to the physiological state (cardiovascular, autonomic, and endocrine nervous system) which is thought to lead to low somatic health if the state is prolonged (Ottaviani et al., 2016). The perseverative cognition is defined as the repetitive or sustained activation of cognitive representations of past stressful events or feared events in the future (Brosschot, Gerin, & Thayer, 2006), such as rumination and worries about these. The results concerning psychosomatic symptoms is consistent with the fact that nonjudging and acting with awareness showed a slightly stronger negative correlation with rumination than other facets (Alleva, Roelofs, Voncken, Meevissen, & Alberts, 2014; Petrocchi & Ottaviani, 2016; Short & Mazmanian, 2013). However, nonreactivity showed a slightly stronger negative correlation with worry than other facets (de Bruin et al., 2012). Further research is necessary to examine why nonjudging and acting with awareness have a specific effect on psychosomatic symptoms in the mediation model of SPS.

These results imply that the improvement of dispositional mindfulness may be effective for the psychological and physical problems of highly sensitive people. Our results have potential applications in clinical practice for highly sensitive people, because dispositional mindfulness is a factor that can be changed by mindfulness training, whereas SPS is considered an inherent factor. Furthermore, it has been noted that those with high SPS may tend to be more influenced by the quality of their environment than those with low SPS (Aron et al., 2012). That is, people with high SPS may show more of a positive outcome if supportive environment is provided, although they may show more of a negative outcome if a nonsupportive environment is provided, than people with low SPS. It has been shown that SPS predicted the treatment response to a school-based depression prevention intervention for children (Pluess & Boniwell, 2015). In that study, the depression of children with high SPS was significantly reduced, whereas that of those with low SPS did not. Given the high responsivity of SPS, it may be that mindfulness treatment would have significant effect on the psychological and physical problems of people with high SPS.

Limitations

We were unable to show any evidence of a causal relationship between SPS, dispositional mindfulness, and psychological and physical problems, because this was a cross-sectional study. Future studies with longitudinal and/or intervention designs are needed to examine the causal relationship.

Although both SPS (Jagiellowicz et al., 2011) and dispositional mindfulness (Zhuang et al., 2017) have been shown to relate to biological and physiological measures, only self-reported measures were used in this study. Furthermore, some problems in the measurement of mindfulness by self-reported measures have been noted (Grossman, 2008). It is necessary to measure SPS and dispositional mindfulness using multiple measures, including behavioral and physiological measures for more valid assessment.

It is possible that a negative mood induction inserted between scales (Takahashi et al., 2015) had some influence on the measurements that followed the induction, namely, HSCL and WHO-5 (see Measures). However, the influence was probably minimal, because both HSCL and WHO-5 concern past states (over the last week and the last two weeks, respectively); further, moods (positive, anxious, and depressive moods measured by DAMS) after the mood induction showed a nonsignificant and very small correlation (.03–.08) with HSCL and WHO-5, when controlled for baseline moods. Although we conclude that the mood induction procedure did not distort the main results, the results should be replicated in another investigation.

Footnotes

Acknowledgments

The authors would like to thank Enago () for the English language review. The authors would also like to thank Yuko Hakamata and Tetsuya Kawamoto for their advice about planning research and Tomosumi Haitani for his advice about the manuscript. Additionally, this research was partially supported by the Commissioned Research of NICT.

Article Notes

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