The effects of mindfulness-based stress reduction (MBSR) on the association between autonomic interoceptive signals and emotion regulation selection Author: Ziv Ardi1, Yulia Golland, Roni Shafir, Gal Sheppes, Nava Levit-Binnun Affiliation: <sup>1</sup> Sagol Center for Brain and Mind, Baruch Ivcher School of Psychology, Interdisciplinary Center, Herzliya, Israel Department of Behavioral Sciences. Kinneret Academic College, Sea of Galilee, Israel. The School of Psychological Sciences, and Sagol School of Neuroscience, Tel Aviv University. Conference/Journal: Psychosom Med Date published: 2021 Aug 12 Other: Special Notes: doi: 10.1097/PSY.0000000000000994. , Word Count: 287 Objectives: The ability to select the most adaptive regulatory strategy as a function of the emotional context plays a pivotal role in psychological health. Recently, we showed that mindfulness-based interventions (MBIs) can improve the sensitivity of regulatory strategy selection to emotional intensity. Yet, the mechanisms underlying this improvement are unclear. In this study we tested the hypothesis that MBIs support adaptive regulatory selection by increasing sensitivity to interoceptive signals associated with the emotional stimuli. Methods: Participants (N = 84, mean ± SD age = 30.9 ± 8.3; 54% women) were randomized to either a Mindfulness-Based Stress Reduction (MBSR) program or a waitlist control condition. Before and after the MBSR program, physiological measures for autonomic nervous system activity were obtained and participants performed a task examining emotion regulation selections (reappraisal vs. distraction) when confronted with low or high negative intensity images. They also completed a battery of mindfulness, interoception and wellbeing self-report measures. A cross-classified model was employed for the main analyses. Results: The participants assigned to the MBSR were overall more likely to choose reappraisal than distraction (b = 0.26, posterior SD = 0.13, 95% CI [0.02, 0.52]) after the program. Interoceptive signals in response to negative images were associated with subsequent regulatory selections (b = 0.02, posterior SD = 0.01, 95% CI [0.01, 0.03]) in the MBSR group. Specifically, lower cardiac reactivity was associated with the choice to reappraise whereas higher cardiac reactivity was related to the choice to distract. Greater differences in cardiac reactivity between states that prompt reappraisal and states that prompt distraction were associated with higher wellbeing (Satisfaction with Life Scale, Pearson r (29) = .527, p = 0.003). Conclusion: Mindfulness appears to increase the sensitivity of regulatory selections to interoceptive signals, and this is associated with subjective wellbeing. This may be a central pathway through which MBIs exert their positive effects on mental health and resilience. PMID: 34387225 DOI: 10.1097/PSY.0000000000000994