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Mindful Breathing and Mindful Body Scan Techniques’ Effect on Anxiety and Depression
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Elainna E. Simpson
Psychology Department, Loras College
PSY331: Clinical Psychology
Dr. Lauritsen
October 11, 2020
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Mindful Breathing and Mindful Body Scan Techniques’ Effect on Anxiety and Depression
Features
Mindfulness is the relationship of being present in the moment while paying attention to

your body and mind. During this time, it is important to be non-judgmental towards yourself.

Often, mindfulness techniques can ground you in the moment and allow you to understand your

body and thoughts and respond in a calmer state. Although mindfulness can take many forms,

the most common is the differing practices of meditation. Mindfulness interventions have been

shown to not only decrease people’s stress levels but also to decrease people’s levels of anxiety

(Cavanagh et al., 2014; Corbett et al., 2019; Diaz et al., 2018; Feldman et al., 2010).

Mindfulness-based stress reduction (MBSR) is a form of mindfulness intervention that

takes place over several weeks and focuses on training people to utilize mindfulness techniques.

Over time, participants gain the ability to be more mindful and therefore are more likely to reap

the benefits of mindfulness. Baer et al. (2012) researched how people gain mindfulness skills

over time and when the effects of mindfulness start to occur. Participants suffering from either

pain or stress complaints were enrolled in an MBSR group treatment program that met weekly

for 8 weeks. The mindfulness techniques utilized in this study were a combination of

mindfulness body scan, sitting meditation, and gentle yoga. Not only were mindfulness skills and

perceived stress assessed pre- and post-treatment, but also on a weekly basis to determine

development. The results demonstrate significantly higher levels of mindfulness after treatment

compared to before treatment, which indicates that the participants did improve their ability to

use mindfulness strategies. There was also a significant decrease in perceived stress after the

MBSR intervention, which indicates that the mindfulness training helped to lower the

participant’s perceived stress. The main finding of this paper was that perceived stress changes
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came after changes in mindfulness skills. These findings demonstrate that participants only

experienced changes in their perceived stress after they had improved their mindfulness skills

(Baer et al., 2012). To better understand MBSR treatment in a mental health facility, Diaz et al.

(2018) researched mindfulness-based interventions in adolescents already receiving mental

health treatment. Participants attended an 8-week formal session that included sitting or moving

meditation, body-scan, and hatha yoga exercises. The participants were also asked to practice

mindfulness at home for 25-30 minutes a day with recordings. One group received MBSR

treatment alongside their usual treatment (MBSR + TAU) while the control group just received

treatment as usual (TAU). The MBSR + TAU group had a statistically significant decrease in

anxiety compared to the TAU group, while other symptoms (depression, paranoia, and perceived

stress) had only an observed improvement in the MBSR + TAU group. Many participants found

practicing at home difficult, but researchers suggest that this is because the participants were all

adolescents. Researchers also found that adolescents who had higher scores in anxiety were more

likely to benefit more from the MBSR treatment. This research demonstrates the importance of

mindfulness in clinical settings for adolescents to learn strategies to improve their symptoms

(Diaz et al., 2018).

Although MBSR training has been identified as a beneficial form of mindfulness, it is

intensive and not always accessible to those who need it. As mindfulness techniques became

more popular, a wide range of self-help options have been made available through workbooks,

internet programs, or audio recordings. A meta-analysis was conducted to determine if self-help

mindfulness interventions would also increase mindfulness skills and possibly even reduce

symptoms of anxiety and depression. The results of this meta-analysis indicate that self-help

interventions resulted in significantly higher levels of mindfulness skills, therefore this type of
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mindfulness intervention is successful. The interventions also significantly lowered the levels of

anxiety and depression symptoms compared to controls, indicating the clinical importance of

these self-help methods (Cavanagh et al., 2014).

Two mindfulness strategies are body scan and mindful breathing. A body scan is a guided

meditation that focuses attention on specific body parts. This mindfulness technique allows you

to be more aware of your body and relieve any tension it holds. To determine the effect of the

body scan compared to muscle relaxation techniques, researchers had studied each technique’s

effects on participant’s stress and anxiety levels (Corbett et al., 2019). Participants were assigned

to either technique, where they attended classes and were provided audio recordings to use

between classes. Both of the treatment groups indicated a significant decrease in participant’s

levels of stress and anxiety from pre-treatment baselines to post-treatment. Despite these

findings, only the body scan group showed a significant improvement in depression from pre-

treatment to post-treatment. Both of these findings also had significant effects from pre-treatment

to 3 months after the intervention. Consequently, this study offers evidence that body scan can be

a useful mindfulness technique compared to others since it can be beneficial in decreasing stress

and depression levels (Corbett et al., 2019). Another common mindfulness technique is mindful

breathing. Mindful breathing focuses attention on the breath and allows decentering, or

considering many aspects of a situation. Feldman et al., (2010) researched the effects of mindful

breathing on decentering compared to two other strategies: progressive muscle relaxation and

loving-kindness meditation. Participants were assigned randomly to a group and completed a 15-

minute audio led exercise particular to the group assignment. The results demonstrate that the

mindful breathing group experienced greater decentering compared to the other two groups.

Since decentering was measured by repetitive thoughts and negative reactivity to those thoughts,
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researchers suggest that mindful breathing must be uniquely able to reduce these behaviors. This

mindfulness technique could assist those with anxiety, depression, high stress, anger problems,

etc. Both body scan and mindful breathing are strong mindfulness techniques that can assist with

anxiety and stress.

Based on the literature, this research aims to determine whether the mindfulness

techniques of body scan and mindful breathing can improve anxiety and depression

symptomology in the case subject. Utilizing the Positive and Negative Affect Schedule

(PANAS), anxiety is classified as a low positive affect (PA) and depression is classified as a high

negative affect (NA) (Watson et al., 1988). I hypothesize that guided audio practice of both body

scan and mindful breathing two days a week (per each technique), for two weeks will decrease

anxiety and depression symptomology measured with the PANAS.

Materials and Methods

Case Subject

The subject of this case study, ES, is a 21-year-old female college student. ES is

Caucasian and resides in the Midwest of the United States. The test subject was diagnosed with

major depressive disorder and generalized anxiety disorder at the age of 12 and has persisting

symptoms. ES is currently not on medications but does occasionally see a therapist.

Procedure

The case subject will undergo a mindfulness-based intervention utilizing audio recordings

from UC Berkley’s website Greater Good in Action. Both the mindful breathing exercise and the

body scan audio exercises will be used within this study. The mindful breathing exercise is a

meditation where you focus attention on your breath. This exercise is often done in a comfortable
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sitting position with the eyes closed. The guided audio, which is 5 minutes and 31 seconds, talks

you through the practice where you focus on yourself and your breathing while always bringing

your attention back after it wanders away (UC Berkley). The body scan meditation focuses

attention on the body and different sensations from different body parts. This exercise can be

done in a sitting position with eyes closed or open. The body scan meditation also has guided

audio, which is 2 minutes and 44 seconds. This form of meditation focuses on feeling the

sensations of each body part one at a time and then relaxing that body part. These sensations are

often weight, pressure, vibration, and temperature (UC Berkley).

These practices will be done over 2 weeks, with a total of 8 sessions. The body scan

technique will be done on Monday and Wednesday of the first week and Tuesday and Thursday

of the second week. The mindful breathing exercise will be done Tuesday and Thursday of the

first week and Monday and Wednesday of the second week. The switching of weekdays half-

way through the intervention is an attempt to counterbalance any confounding variables related

to the specific days of the week. Each intervention will occur in the case subject’s bedroom at

noon on the days of the intervention.

Measures and Data Analysis

The Positive and Negative Affect Schedule (PANAS) will be utilized to measure feelings

and emotions. The PANAS, created by Watson et al. (1988), is a self-report assessment of mood

focused on two factors, positive and negative affect. Positive affect (PA) is characteristic of

mood that is excited, alert, and attentive; the higher the score indicates the more positive

someone’s mood is. Negative affect (NA) is characteristic of sadness, distress, and anger; a

lower score indicates a lack of negative mood. These two factors of the PANAS are negatively

correlated and therefore are opposites of each other. The PANAS includes 20 mood description
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words that are evenly distributed between PA and NA. Each mood description word is meant to

be assigned a number on a Likert scale to demonstrate the extent someone feels that way in the

moment or over a week. The Likert scale is from 1 which signifies “very slightly or not at all” to

5 which signifies “extremely”. Positive affect scores can range from 10-50, with mean scores for

momentary feeling at 29.7 (SD = 7.9) and the mean weekly score at 33.3 (SD = 7.2). Negative

Affect scores can range from 10-50, with mean scores for momentary feeling at 14.8 (SD = 6.2)

and mean weekly score at 17.4 (SD = 6.2) (Watson et al., 1988). ES will utilize the PANAS by

reporting momentary mood, rather than weekly mood. Specifically, the results of the PANAS

will be analyzed in terms of anxiety and depression features. A low PA is associated with

anxiety, and a high NA is associated with depression (Watson et al., 1988). The PANAS also has

strong reliability especially in test-retest showing stability over time. This measurement also has

strong external validity since it correlates well with other related scales, which show that the

scales could be interchangeable. Overall, the PANAS scale is reliable, valid, and a more efficient

tool in determining affect (Watson et al., 1988).

The case subject will have a pre-intervention baseline measured the Sunday before the

start of the intervention. Immediately after each intervention (every Monday, Tuesday,

Wednesday, and Thursday), the test subject will be measured based on the PANAS. This

continued measurement may provide added insight on which intervention is more successful or

solidify the progress of the mindfulness intervention. The Friday after the intervention is

complete, a post-intervention PANAS measurement will be completed.

Pre- and post-intervention PANAS scores will be compared. Data analysis using two

different paired samples T-test will compare the different meditations (body scan and mindful
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breathing) in positive affect PANAS scores and then negative affect PANAS scores. Qualitative

observations will also be presented.

Results

Quantitative Findings

The case subject took the PANAS before and after the intervention to compare scores in

negative and positive affect as a result of the mindfulness intervention. In the positive affect

subscale of the PANAS, ES had a pre-intervention score of 23. This score is below the mean,

29.7, for the PA scale of the PANAS. The post-intervention score for PA for ES was 17,

indicating a decrease in PA from pre to post-intervention (See Figure 1). When analyzing the

negative affect subscale of the PANAS, ES had a pre-intervention score of 22. This score is

above the mean, 14.8, for the NA scale of the PANAS. The post-intervention NA PANAS score

for ES was 13. This post-intervention score is below the mean for NA and indicates a decrease in

NA after the mindfulness intervention (See Figure 2). Overall the PANAS scores throughout the

intervention fluctuated (See Figure 3). Some general trends were that the PA scores were always

under the mean for the scale, both PA and NA seemed to decline over the week, and scores did

fluctuate for both interventions.

A paired-samples T-test was performed to compare the body scan meditation PANAS

scores to the mindful breathing meditation PANAS scores. When analyzing the positive affect

subscale, there was no significant difference in the PANAS scores for the body scan meditation

(M = 20.25, SD = 3.59) and the mindful breathing meditation (M = 19.25, SD = 0.96)

interventions (t(3) = 0.63, p = 0.572). The negative affect subscale also showed no significant
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difference in the PANAS scores for the body scan meditation (M = 15.25, SD = 6.92) and

mindful breathing meditation (M = 15.25, SD = 2.92) interventions (t(3) = 0, p = 1).

Qualitative Findings

Alongside the quantitative findings, qualitative findings were observed throughout the

week. During the weekly intervention, the meditations did seem to calm symptoms of stress,

anxiety, or depression right after the meditation but calming these symptoms during the

meditation did vary day-to-day. ES felt that the body scan was better to calm anxiety compared

to mindful breathing since it had a more structured audio file which caused less overthinking.

Alternatively, mindful breathing seemed to be more beneficial for depressive symptoms during

the meditation because it grounds you in the present and makes you feel grateful.

One issue with intervention implementation was an issue with the scheduled time. Noon

every day was the chosen time due to its availability, but also so the meditation could break up a

busy day. There were two times where the intervention was not done at noon but was done as

soon as possible. This could have affected quantitative and qualitative findings. All other aspects

of the intervention followed the details in the methods section.

Conclusion

This research hypothesized that both body scan and mindfulness meditations would

improve anxiety and depression symptomology utilizing the PANAS. The results of the

intervention only support that depressive symptomology improved after the 8-day mindfulness

intervention. The PANAS can show anxiety through a low PA based on the mean for the PA

scale which is 29.7. Similarly, depression is shown in the PANAS through a high NA based on a

mean NA score, 14.8. The pre-intervention score for NA was 22 indicating a higher NA and
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therefore depressive-like affect, but after the intervention the NA score was 13 which is slightly

under the mean (see Figure 2). This data suggests that although there was not an extreme effect

on depressive symptoms, the interventions appear to have caused a lower depressive score.

Surprisingly, PA showed a decrease in scores from pre- to post-intervention, showing that it

either did not affect anxiety or potentially made it worse. These results don’t support the

hypothesis. As shown in Figure 3, there was a lot of fluctuation in scores throughout the week,

yet this did not seem to be affected by the type of meditation used. The paired-samples T-tests

demonstrated that there was no significant difference in the PANAS scores for PA or NA

between the different mindfulness techniques, body scan and mindful breathing. These results

show that these interventions do not have different effects on the different subscales. Qualitative

findings indicate that the case subject felt the body scan meditation was better at treating anxiety

symptoms compared to depressive due to the structured format of the audio file. Conversely, the

mindful breathing seemed to qualitatively be more beneficial to depressive symptoms due to the

simplicity of the tape in grounding someone in the present. These findings were not supported by

the quantitative results discussed above but could help with clinical application.

Although research on mindfulness intervention focuses on positive effects on anxiety,

those results were not replicated within this study (Baer et al., 2012; Cavanaugh et al., 2014;

Corbett et al., 2019; Diaz et al., 2018; Feldman et al., 2010). Corbett et al. (2019) and Feldman et

al. (2010) both specifically used the same mindfulness techniques of body scan and mindful

breathing and both found decreases in anxiety levels, which contrasts the results of this study.

Only two studies in this literature review show a decrease in depressive symptoms which aligns

with the results of this study. Feldman et al. (2010) specifically saw mindful breathing

techniques to be beneficial to decentering and improve depression scores, similarly to our results.
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Diaz et al. (2018) showcased similar results where MBSR treatment groups had an observed

decrease in depression.

One possible reason the results from the literature were not replicated was that most

studies involved a longer time learning and practicing the skills of mindfulness. As Baer et al.

(2012) discuss, the learning of mindfulness skills often precedes the benefits and since the time

for this intervention was short and did not include professional guidance, it’s possible that

mindfulness skills were never fully established. The meta-analysis performed by Cavanaugh et

al. (2014), showed that self-help interventions, much like this study, can cause a lowering in

depression and anxiety. Perhaps, the change in anxiety requires more time to complete the

interventions since that result was not replicated. One large factor that could contribute to this

lack of replication in other studies is the use of the PANAS. Although it is a reliable tool to

assess mood, it was not used within the literature to measure anxiety and depression symptoms.

This could mean that the PANAS is not the most useful assessment tool to determine the effects

of mindfulness in depression and anxiety, despite this symptomology’s correlation to affect.

There were also other limitations within this study that could have greatly affected the

results. First was the time of the year this intervention took place. This mindfulness intervention

occurred around a stressful period in the college semester for ES and levels of anxiety and

depression overall could have been affected by this. This could also indicate some strength in

mindfulness interventions to improve depressive symptoms since the results indicated this

change despite the environmental stressors. Future research could compare the results of this

study to a replication study during a less stressful time for the case subject. Also, as mentioned in

the results, there were two inconsistencies with the time of intervention which could have caused

an effect on the results for those days. Lastly, the fact that this was a case study limits the scope
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and application of the results. This also hindered data analysis since there was limited data due to

sample size. These limitations alongside the limitations mentioned previously (the use of the

PANAS, length of intervention, and no professional MBSR treatment) could have affected

results and showcase the need for replication and revised methodology.

Future research on mindfulness could clarify its effects on depression and anxiety. There

appears to be a lack of research specifically investigating the effects of mindfulness on

depression. Although this study demonstrated a change in depression symptomology, other

studies are required to validate these results. More information on the utility of the PANAS in

mindfulness research, specifically analyzing depression and anxiety, could be beneficial to future

research on this topic. Lastly, this study focused on the effects meditation has on negative

symptomology, but it is incredibly important to also study how these techniques can improve

happiness and well-being which over time could lead to effects in mental health symptomology.

This case study demonstrated that mindfulness techniques, specifically body scan

meditation and mindful breathing meditation, can decrease depressive-like affect. The results

also suggest that there was no significant difference between the two mindfulness interventions

on both PA and NA. Despite some limitations and inconsistencies with past research, the results

do indicate the beneficial use of these mindfulness techniques on the case study subject.
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References

Baer, R. A., Carmody, J., & Hunsinger, M. (2012). Weekly change in mindfulness and perceived

stress in a mindfulness-based stress reduction program. Journal of Clinical Psychology,

68(7), 755–765. doi:10.1002/jclp.21865

Cavanagh, K., Strauss, C., Forder, L., & Jones, F. (2014). Can mindfulness and acceptance be

learnt by self-help?: A systematic review and meta-analysis of mindfulness and acceptance-

based self-help interventions. Clinical Psychology Review, 34(2), 118–129.

doi:10.1016/j.cpr.2014.01.001

Corbett, D. C., Egan, D. J., & Pilch, M. (2019). A randomised comparison of two “stress

control” programmes: Progressive muscle relaxation versus mindfulness body scan. Mental

Health & Prevention, 200163. doi:10.1016/j.mph.2019.200163

Díaz-González, M. C., Pérez Dueñas, C., Sanchez-Raya, A., Moriana Elvira, J. A., & Sánchez

Vázquez, V. (2018). Mindfulness-based stress reduction in adolescents with mental

disorders: A randomised clinical trial. Psicothema, 30(2), 165-170.

Feldman, G., Greeson, J., & Senville, J. (2010). Differential effects of mindful breathing,

progressive muscle relaxation, and loving-kindness meditation on decentering and

negative reactions to repetitive thoughts. Behaviour Research and Therapy, 48(10), 1002–

1011. doi:10.1016/j.brat.2010.06.006

UC Berkley. (n.d.). Greater Good in Action. Retrieved October 13, 2020, from

https://ggia.berkeley.edu/
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Watson, D., Clark, L. A., & Tellegen, A. (1988). Development and validation of brief measures

of positive and negative affect: the PANAS scales. Journal of Personality and Social

Psychology, 54(6), 1063.

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Figure 1: Positive Affect PANAS scores from before mindfulness intervention to after

mindfulness intervention.

Figure 1: Pre-intervention score was 23, well below the PA mean of 29.7. The PANAS score

post-intervention was 17, which shows a drop in PA score. This graph shows there was a

decrease in positive affect throughout the intervention. These scores do not support the

hypothesis, specifically, that anxiety (a low PA) was not improved due to the mindfulness

intervention.
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Figure 2: Negative Affect PANAS scores from before mindfulness intervention to after

mindfulness intervention.

Negative Affect PANAS Scores Pre- to Post-Mindfulness

Intervention
25

20
Negative Affect PANAS Scores

15

10

0
Pre-Intervention Post-Intervention

Figure 2: The pre-intervention NA score from the PANAS was 22, which is well above the mean

of 14.8 indicating a high negative affect. The NA decreased after the mindfulness intervention to

a score of 13 which is just below the mean. This graph shows that ES had less negative affect

after the intervention than before. This does support the hypothesis that the mindfulness

interventions improved NA and since the score is slightly below the mean, it improved

depression-like NA.
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Figure 3: PA and NA PANAS Scores through the course of the mindfulness intervention.

Figure 3: This
graph showcases the fluctuations for each day on PANAS scores for both PA and NA. The NA
score decreased from pre- to post-intervention. Towards the end of the week, there appears to be
a lower PA score than the beginning of the week.
Days 1,3, 6,8 the body scan meditation was done.
Days 2,4,5,7 the mindful breathing meditation was done.