{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,6,10]],"date-time":"2025-06-10T04:06:30Z","timestamp":1749528390611,"version":"3.41.0"},"reference-count":76,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T00:00:00Z","timestamp":1749427200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"NIHR CLAHRC East Midlands"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS One"],"abstract":"<jats:p>Depression is a common and growing mental health problem, with around 5% of the world\u2019s population experiencing an episode of depression during their lifetime. Relapse rates are high, with around half experiencing more than one depressive episode and a further 10\u201320% experiencing a chronic and persistent depression. Mindfulness has been incorporated into treatments for depression and several studies have explored the impact of mindfulness training on depressive symptomatology and recurrence. However, to date no studies have looked at the changing relationship between mindfulness and depression in those na\u00efve to mindfulness training. 20 participants with moderate-to-severe persistent depression were interviewed to explore their experience of mindfulness in the context of low mood. Thematic analysis captured six themes highlighting changes in mindfulness relating to the onset of depression. Themes included: behavioural withdrawal; perceptual detachment from one\u2019s experience; intentional reduction in awareness; increased self-criticism; mind racing; impaired cognitive performance. Thematic analysis suggested that mindfulness reduces in the context of moderate-to-severe persistent depression. This appears to occur indirectly as the consequence of depression-related processes, e.g., rumination and experiential avoidance, but also arises as a deliberately instigated self-protective strategy. However, findings seemed to indicate that reduced mindfulness maintains and intensifies depressive experience. Despite growing evidence of the value of mindfulness approaches for those with more chronic and severe depression, study findings suggest that introducing mindfulness to this population may be particularly challenging due to the intensity of symptomatology potentially obstructing access to a mindful perspective. Findings bear important implications for the treatment of depression and can inform future intervention development and delivery.<\/jats:p>","DOI":"10.1371\/journal.pone.0323294","type":"journal-article","created":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T17:46:56Z","timestamp":1749491216000},"page":"e0323294","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":0,"title":["A qualitative exploration into the experience of mindfulness in moderate-severe persistent depression"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2591-7619","authenticated-orcid":true,"given":"Timothy","family":"Sweeney","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4750-7522","authenticated-orcid":true,"given":"Elena","family":"Nixon","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2910-4121","authenticated-orcid":true,"given":"Richard","family":"Morriss","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Patrick","family":"Callaghan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"340","published-online":{"date-parts":[[2025,6,9]]},"reference":[{"key":"pone.0323294.ref001","author":"World Health Organization","year":"2015"},{"key":"pone.0323294.ref002","unstructured":"World Health Organization. Report on mental health systems in Central America and Dominican Republic using the World Health Organization Assessment Instrument for Mental Health Systems. 2009."},{"key":"pone.0323294.ref003","doi-asserted-by":"crossref","DOI":"10.1596\/978-0-8213-6262-4","article-title":"Disease Control Priorities Project","volume-title":"Global burden of disease and risk factors","author":"AD Lopez","year":"2006"},{"issue":"16","key":"pone.0323294.ref004","first-page":"81","article-title":"The burden of disease for treatment-resistant depression","volume":"62","author":"J Greden","year":"2001","journal-title":"The Journal of Clinical Psychiatry"},{"key":"pone.0323294.ref005","volume-title":"Depression in adults: Treatment and management","author":"National Institute for Health and Clinical Excellence","year":"2022"},{"key":"pone.0323294.ref006","volume-title":"Full Catastrophe Living: How to Cope with Stress, Pain and Illness Using Mindfulness Meditation","author":"J Kabat-Zinn","year":"1990"},{"key":"pone.0323294.ref007","volume-title":"Mindfulness-based cognitive therapy for depression: a new approach to preventing relapse","author":"ZV Segal","year":"2013"},{"issue":"4","key":"pone.0323294.ref008","doi-asserted-by":"crossref","first-page":"615","DOI":"10.1037\/0022-006X.68.4.615","article-title":"Prevention of relapse\/recurrence in major depression by mindfulness-based cognitive therapy","volume":"68","author":"JD Teasdale","year":"2000","journal-title":"J Consult Clin Psychol"},{"issue":"1","key":"pone.0323294.ref009","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1037\/0022-006X.72.1.31","article-title":"Mindfulness-based cognitive therapy for depression: replication and exploration of differential relapse prevention effects","volume":"72","author":"SH Ma","year":"2004","journal-title":"J Consult Clin Psychol"},{"issue":"6","key":"pone.0323294.ref010","doi-asserted-by":"crossref","first-page":"966","DOI":"10.1037\/a0013786","article-title":"Mindfulness-based cognitive therapy to prevent relapse in recurrent depression","volume":"76","author":"W Kuyken","year":"2008","journal-title":"J Consult Clin Psychol"},{"issue":"6","key":"pone.0323294.ref011","doi-asserted-by":"crossref","first-page":"565","DOI":"10.1001\/jamapsychiatry.2016.0076","article-title":"Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse","volume":"73","author":"W Kuyken","year":"2016","journal-title":"JAMA Psychiatry"},{"key":"pone.0323294.ref012","doi-asserted-by":"crossref","first-page":"14","DOI":"10.1186\/1471-244X-6-14","article-title":"An exploratory mixed methods study of the acceptability and effectiveness of Mindfulness-Based Cognitive Therapy for patients with active depression and anxiety in primary care","volume":"6","author":"A Finucane","year":"2006","journal-title":"BMC Psychiatry"},{"key":"pone.0323294.ref013","doi-asserted-by":"crossref","first-page":"138","DOI":"10.1016\/j.jad.2010.09.027","article-title":"Mindfulness-based cognitive therapy vs cognitive behaviour therapy as a treatment for non-melancholic depression","volume":"130","author":"V Manicavasgar","year":"2011","journal-title":"J Affect Disord"},{"key":"pone.0323294.ref014","doi-asserted-by":"crossref","first-page":"193","DOI":"10.1348\/147608306X116016","article-title":"Mindfulness-based cognitive therapy for residual depressive symptoms","volume":"80","author":"T Kingston","year":"2007","journal-title":"Psychol Psychother"},{"issue":"5","key":"pone.0323294.ref015","doi-asserted-by":"crossref","first-page":"989","DOI":"10.1017\/S0033291711002054","article-title":"The efficacy of mindfulness-based cognitive therapy in recurrent depressed patients with and without a current depressive episode: a randomized controlled trial","volume":"42","author":"JR van Aalderen","year":"2012","journal-title":"Psychol Med"},{"issue":"3","key":"pone.0323294.ref016","doi-asserted-by":"crossref","first-page":"617","DOI":"10.1016\/j.brat.2006.04.008","article-title":"Treatment-resistant depressed patients show a good response to Mindfulness-based Cognitive Therapy","volume":"45","author":"MA Kenny","year":"2007","journal-title":"Behav Res Ther"},{"issue":"5","key":"pone.0323294.ref017","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1159\/000142525","article-title":"Mindfulness-based cognitive therapy for treatment-resistant depression: a pilot study","volume":"77","author":"SJ Eisendrath","year":"2008","journal-title":"Psychother Psychosom"},{"issue":"5","key":"pone.0323294.ref018","doi-asserted-by":"crossref","first-page":"366","DOI":"10.1016\/j.brat.2009.01.019","article-title":"Mindfulness-based cognitive therapy as a treatment for chronic depression: A preliminary study","volume":"47","author":"T Barnhofer","year":"2009","journal-title":"Behav Res Ther"},{"issue":"2","key":"pone.0323294.ref019","doi-asserted-by":"crossref","first-page":"99","DOI":"10.1159\/000442260","article-title":"A Randomized Controlled Trial of Mindfulness-Based Cognitive Therapy for Treatment-Resistant Depression","volume":"85","author":"SJ Eisendrath","year":"2016","journal-title":"Psychother Psychosom"},{"key":"pone.0323294.ref020","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1348\/000711201160911","article-title":"A qualitative study of mindfulness-based cognitive therapy for depression","volume":"74","author":"O Mason","year":"2001","journal-title":"Br J Med Psychol"},{"issue":"4","key":"pone.0323294.ref021","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1007\/s12671-011-0070-5","article-title":"A Grounded-Theory Study of Mindfulness Practice Following Mindfulness-Based Cognitive Therapy","volume":"2","author":"S Langdon","year":"2011","journal-title":"Mindfulness"},{"issue":"6","key":"pone.0323294.ref022","doi-asserted-by":"crossref","first-page":"603","DOI":"10.1111\/j.1365-2850.2007.01148.x","article-title":"A qualitative study into the experience of individuals involved in a mindfulness group within an acute inpatient mental health unit","volume":"14","author":"M York","year":"2007","journal-title":"J Psychiatr Ment Health Nurs"},{"issue":"4","key":"pone.0323294.ref023","doi-asserted-by":"crossref","first-page":"413","DOI":"10.1017\/S135246580999004X","article-title":"Participants\u2019 experiences of mindfulness-based cognitive therapy: \u201cIt changed me in just about every way possible\u201d","volume":"37","author":"M Allen","year":"2009","journal-title":"Behav Cogn Psychother"},{"issue":"1","key":"pone.0323294.ref024","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1007\/s12671-012-0146-x","article-title":"Relating Mindfully: A Qualitative Exploration of Changes in Relationships Through Mindfulness-Based Cognitive Therapy","volume":"5","author":"JLN Bihari","year":"2012","journal-title":"Mindfulness"},{"issue":"5","key":"pone.0323294.ref025","doi-asserted-by":"crossref","first-page":"1181","DOI":"10.1007\/s12671-014-0370-7","article-title":"MBCT for Patients with Respiratory Conditions Who Experience Anxiety and Depression: A Qualitative Study","volume":"6","author":"A Malpass","year":"2015","journal-title":"Mindfulness"},{"issue":"1","key":"pone.0323294.ref026","doi-asserted-by":"crossref","first-page":"60","DOI":"10.1007\/s12671-011-0081-2","article-title":"Transforming the Perceptual Situation: a Meta-ethnography of qualitative Work Reporting Patients\u2019 Experiences of Mindfulness-Based Approaches","volume":"3","author":"A Malpass","year":"2011","journal-title":"Mindfulness"},{"issue":"1","key":"pone.0323294.ref027","first-page":"9","article-title":"The effects of mindfulness-based cognitive therapy: a qualitative approach","volume":"13","author":"AIT Cebolla","year":"2009","journal-title":"Psychology in Spain"},{"issue":"5","key":"pone.0323294.ref028","doi-asserted-by":"crossref","first-page":"1494","DOI":"10.1002\/cpp.2773","article-title":"A systematic review and meta-ethnographic synthesis of Mindfulness-based Cognitive Therapy for people with major depression","volume":"29","author":"K Williams","year":"2022","journal-title":"Clin Psychol Psychother"},{"issue":"1","key":"pone.0323294.ref029","doi-asserted-by":"crossref","first-page":"80","DOI":"10.1002\/cpp.700","article-title":"Developing an observing attitude: an analysis of meditation diaries in an MBSR clinical trial","volume":"18","author":"CE Kerr","year":"2011","journal-title":"Clin Psychol Psychother"},{"issue":"2","key":"pone.0323294.ref030","doi-asserted-by":"crossref","DOI":"10.1136\/bmjopen-2019-033892","article-title":"Recovery from recurrent depression with mindfulness-based cognitive therapy and antidepressants: a qualitative study with illustrative case studies","volume":"10","author":"A Tickell","year":"2020","journal-title":"BMJ Open"},{"key":"pone.0323294.ref031","doi-asserted-by":"crossref","DOI":"10.1176\/appi.books.9780890425596","volume-title":"Diagnostic and statistical manual of mental disorders: DSM-5","author":"Association American Psychiatric","year":"2013"},{"issue":"314","key":"pone.0323294.ref032","first-page":"393","article-title":"Double-blind placebo-controlled trial of amitriptyline among depressed patients in general practice","volume":"38","author":"JA Hollyman","year":"1988","journal-title":"J R Coll Gen Pract"},{"issue":"3","key":"pone.0323294.ref033","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1016\/S0033-3182(95)71666-8","article-title":"Global Assessment of Functioning","volume":"36","author":"RCW Hall","year":"1995","journal-title":"Psychosomatics"},{"issue":"2","key":"pone.0323294.ref034","doi-asserted-by":"crossref","first-page":"77","DOI":"10.1191\/1478088706qp063oa","article-title":"Using thematic analysis in psychology","volume":"3","author":"V Braun","year":"2006","journal-title":"Qualitative Research in Psychology"},{"key":"pone.0323294.ref035","volume-title":"Nursing Research: Principles and Methods","author":"DF Polit","year":"2012"},{"issue":"1","key":"pone.0323294.ref036","doi-asserted-by":"crossref","first-page":"27","DOI":"10.1177\/1073191105283504","article-title":"Using self-report assessment methods to explore facets of mindfulness","volume":"13","author":"RA Baer","year":"2006","journal-title":"Assessment"},{"key":"pone.0323294.ref037","volume-title":"Qualitative research methods","author":"P Liamputtong","year":"2009"},{"key":"pone.0323294.ref038","volume-title":"Qualitative Methods for Health Research","author":"J Green","year":"2013"},{"issue":"9","key":"pone.0323294.ref039","doi-asserted-by":"crossref","first-page":"1081","DOI":"10.1176\/ajp.137.9.1081","article-title":"Use of a self-report symptom scale to detect depression in a community sample","volume":"137","year":"1980","journal-title":"American Journal of Psychiatry"},{"issue":"7","key":"pone.0323294.ref040","doi-asserted-by":"crossref","first-page":"755","DOI":"10.1002\/jclp.21865","article-title":"Weekly change in mindfulness and perceived stress in a mindfulness-based stress reduction program","volume":"68","author":"RA Baer","year":"2012","journal-title":"J Clin Psychol"},{"issue":"2","key":"pone.0323294.ref041","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/s12671-011-0085-y","article-title":"Mindfulness and Emotional Well-being in Women with Borderline Personality Disorder","volume":"3","author":"SK O\u2019Toole","year":"2011","journal-title":"Mindfulness"},{"issue":"3","key":"pone.0323294.ref042","doi-asserted-by":"crossref","first-page":"308","DOI":"10.1177\/1073191111408231","article-title":"Psychometric properties of the five facet mindfulness questionnaire in depressed adults and development of a short form","volume":"18","author":"E Bohlmeijer","year":"2011","journal-title":"Assessment"},{"key":"pone.0323294.ref043","volume-title":"Mindful path to self-compassion: Freeing yourself from destructive thoughts and emotions","author":"C Germer","year":"2009"},{"key":"pone.0323294.ref044","volume-title":"The Heart of Buddhist Meditation","author":"a Nyanaponika T h e r","year":"1962"},{"key":"pone.0323294.ref045","volume-title":"Acceptance and Commitment Therapy: An Experiential Approach to Behavior Change","author":"SC Hayes","year":"1999"},{"issue":"4","key":"pone.0323294.ref046","doi-asserted-by":"crossref","first-page":"553","DOI":"10.1007\/BF03395492","article-title":"Measuring experiential avoidance: A preliminary test of a working model","volume":"54","author":"SC Hayes","year":"2004","journal-title":"Psychol Rec"},{"issue":"3","key":"pone.0323294.ref047","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1375\/bech.23.3.165","article-title":"Rumination and Experiential Avoidance in Depression","volume":"23","author":"G Cribb","year":"2006","journal-title":"Behav change"},{"key":"pone.0323294.ref048","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1146\/annurev.psych.53.100901.135103","article-title":"Causes of eating disorders","volume":"53","author":"J Polivy","year":"2002","journal-title":"Annu Rev Psychol"},{"key":"pone.0323294.ref049","doi-asserted-by":"crossref","first-page":"155","DOI":"10.1016\/j.jad.2013.09.001","article-title":"A comparison of vulnerability factors in patients with persistent and remitting lifetime symptom course of depression","author":"T Barnhofer","year":"2014","journal-title":"J Affect Disord"},{"issue":"10","key":"pone.0323294.ref050","doi-asserted-by":"crossref","first-page":"1388","DOI":"10.1177\/1049732311406449","article-title":"Understanding the social interaction difficulties of women with unipolar depression","volume":"21","author":"NM Rice","year":"2011","journal-title":"Qual Health Res"},{"issue":"9","key":"pone.0323294.ref051","doi-asserted-by":"crossref","first-page":"685","DOI":"10.3109\/01612840.2013.789942","article-title":"Major depressive disorder: a qualitative study on the experiences of Iranian patients","volume":"34","author":"K Amini","year":"2013","journal-title":"Issues Ment Health Nurs"},{"issue":"1","key":"pone.0323294.ref052","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1037\/0022-3514.82.1.128","article-title":"Do people with low self-esteem really want to feel better? Self-esteem differences in motivation to repair negative moods","volume":"82","author":"SA Heimpel","year":"2002","journal-title":"J Pers Soc Psychol"},{"issue":"2","key":"pone.0323294.ref053","doi-asserted-by":"crossref","first-page":"134","DOI":"10.1016\/j.whi.2014.12.003","article-title":"Potential for prenatal yoga to serve as an intervention to treat depression during pregnancy","volume":"25","author":"CL Battle","year":"2015","journal-title":"Womens Health Issues"},{"issue":"10","key":"pone.0323294.ref054","first-page":"921","article-title":"\u201cBig build\u201d: hidden depression in men","volume":"39","author":"S Brownhill","year":"2005","journal-title":"Aust N Z J Psychiatry"},{"issue":"2","key":"pone.0323294.ref055","first-page":"133","article-title":"Depression and the ironic effects of thought suppression: Therapeutic strategies for improving mental control","volume":"6","author":"CG Beevers","year":"1999","journal-title":"Clinical Psychology: Science and Practice"},{"key":"pone.0323294.ref056","first-page":"238","article-title":"The mental control of depression: Psychological obstacles to emotional well-being.","volume-title":"Handbook of mental control","author":"RM. Wenzlaff","year":"1993"},{"issue":"11","key":"pone.0323294.ref057","doi-asserted-by":"crossref","first-page":"1029","DOI":"10.1016\/S0005-7967(98)00200-9","article-title":"Thought suppression and psychopathology","volume":"37","author":"C Purdon","year":"1999","journal-title":"Behav Res Ther"},{"key":"pone.0323294.ref058","doi-asserted-by":"crossref","first-page":"59","DOI":"10.1146\/annurev.psych.51.1.59","article-title":"Thought suppression","volume":"51","author":"RM Wenzlaff","year":"2000","journal-title":"Annu Rev Psychol"},{"issue":"5","key":"pone.0323294.ref059","doi-asserted-by":"crossref","first-page":"877","DOI":"10.1016\/S0191-8869(99)00037-9","article-title":"Thought suppression, dissociation and psychopathology","volume":"27","author":"P Spinhoven","year":"1999","journal-title":"Personality and Individual Differences"},{"issue":"4","key":"pone.0323294.ref060","doi-asserted-by":"crossref","first-page":"616","DOI":"10.1111\/j.1467-6494.1994.tb00311.x","article-title":"Chronic thought suppression","volume":"62","author":"DM Wegner","year":"1994","journal-title":"J Pers"},{"issue":"4","key":"pone.0323294.ref061","doi-asserted-by":"crossref","first-page":"435","DOI":"10.1080\/02699930125871","article-title":"Beneath the veil of thought suppression: Attentional bias and depression risk","volume":"15","author":"RM Wenzlaff","year":"2001","journal-title":"Cognition and Emotion"},{"issue":"4","key":"pone.0323294.ref062","doi-asserted-by":"crossref","first-page":"533","DOI":"10.1080\/02699930143000338","article-title":"Cognitive vulnerability to depression: The role of thought suppression and attitude certainty","volume":"16","author":"RM Wenzlaff","year":"2002","journal-title":"Cognition & Emotion"},{"issue":"3","key":"pone.0323294.ref063","doi-asserted-by":"crossref","first-page":"235","DOI":"10.1521\/ijct.2009.2.3.235","article-title":"Thought Control Strategies, Thought Suppression, and Rumination in Depression","volume":"2","author":"ER Watkins","year":"2009","journal-title":"International Journal of Cognitive Therapy"},{"issue":"3","key":"pone.0323294.ref064","doi-asserted-by":"crossref","first-page":"293","DOI":"10.1023\/A:1023966400540","article-title":"The Role of Thought Suppression in Depressive Rumination","volume":"27","author":"RM Wenzlaff","year":"2003","journal-title":"Cognitive Therapy and Research"},{"issue":"1","key":"pone.0323294.ref065","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1037\/0033-295X.101.1.34","article-title":"Ironic processes of mental control","volume":"101","author":"DM Wegner","year":"1994","journal-title":"Psychol Rev"},{"issue":"3","key":"pone.0323294.ref066","doi-asserted-by":"crossref","first-page":"267","DOI":"10.1521\/ijct.2009.2.3.267","article-title":"Mental Control of Unwanted Intrusive Thoughts: A Phenomenological Study of Nonclinical Individuals","volume":"2","author":"DA Clark","year":"2009","journal-title":"International Journal of Cognitive Therapy"},{"issue":"4","key":"pone.0323294.ref067","doi-asserted-by":"crossref","first-page":"569","DOI":"10.1037\/0021-843X.100.4.569","article-title":"Responses to depression and their effects on the duration of depressive episodes","volume":"100","author":"S Nolen-Hoeksema","year":"1991","journal-title":"J Abnorm Psychol"},{"issue":"3","key":"pone.0323294.ref068","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1037\/0022-006X.69.3.347","article-title":"How does cognitive therapy prevent relapse in residual depression? Evidence from a controlled trial","volume":"69","author":"JD Teasdale","year":"2001","journal-title":"J Consult Clin Psychol"},{"issue":"2","key":"pone.0323294.ref069","doi-asserted-by":"crossref","first-page":"197","DOI":"10.1111\/papt.12034","article-title":"Being depleted and being shaken: An interpretative phenomenological analysis of the experiential features of a first episode of depression","volume":"88","author":"JA Smith","year":"2015","journal-title":"Psychol Psychother"},{"issue":"6","key":"pone.0323294.ref070","doi-asserted-by":"crossref","first-page":"1152","DOI":"10.1037\/0022-006X.64.6.1152","article-title":"Experimental avoidance and behavioral disorders: a functional dimensional approach to diagnosis and treatment","volume":"64","author":"SC Hayes","year":"1996","journal-title":"J Consult Clin Psychol"},{"key":"pone.0323294.ref071","doi-asserted-by":"crossref","first-page":"474","DOI":"10.1016\/j.jad.2012.03.019","article-title":"Increased suppression of negative and positive emotions in major depression","volume":"141","author":"T Beblo","year":"2012","journal-title":"J Affect Disord"},{"issue":"1","key":"pone.0323294.ref072","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1037\/1528-3542.3.1.48","article-title":"The social consequences of expressive suppression","volume":"3","author":"EA Butler","year":"2003","journal-title":"Emotion"},{"issue":"9","key":"pone.0323294.ref073","doi-asserted-by":"crossref","first-page":"1251","DOI":"10.1016\/j.brat.2005.10.001","article-title":"Effects of suppression and acceptance on emotional responses of individuals with anxiety and mood disorders","volume":"44","author":"L Campbell-Sills","year":"2006","journal-title":"Behav Res Ther"},{"issue":"1","key":"pone.0323294.ref074","doi-asserted-by":"crossref","first-page":"95","DOI":"10.1037\/0021-843X.106.1.95","article-title":"Hiding feelings: the acute effects of inhibiting negative and positive emotion","volume":"106","author":"JJ Gross","year":"1997","journal-title":"J Abnorm Psychol"},{"issue":"3","key":"pone.0323294.ref075","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1111\/j.1467-6494.2008.00496.x","article-title":"Regulating positive and negative emotions in daily life","volume":"76","author":"JB Nezlek","year":"2008","journal-title":"J Pers"},{"issue":"1","key":"pone.0323294.ref076","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1016\/S0165-1781(02)00300-1","article-title":"Qualitative analysis of verbal fluency in depression","volume":"117","author":"P Fossati","year":"2003","journal-title":"Psychiatry Research"}],"container-title":["PLOS One"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0323294","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,9]],"date-time":"2025-06-09T17:47:12Z","timestamp":1749491232000},"score":1,"resource":{"primary":{"URL":"https:\/\/dx.plos.org\/10.1371\/journal.pone.0323294"}},"subtitle":[],"editor":[{"given":"Simon","family":"White","sequence":"first","affiliation":[],"role":[{"role":"editor","vocabulary":"crossref"}]}],"short-title":[],"issued":{"date-parts":[[2025,6,9]]},"references-count":76,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2025,6,9]]}},"URL":"https:\/\/doi.org\/10.1371\/journal.pone.0323294","relation":{},"ISSN":["1932-6203"],"issn-type":[{"value":"1932-6203","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,6,9]]}}}