Distress tolerance as a mediator of mindfulness-based intervention for anxiety and depression: Evidence from two randomized controlled trials

IF 5.3 1区心理学 Q1 PSYCHOLOGY, CLINICAL International Journal of Clinical and Health Psychology Pub Date : 2024-02-01 DOI:10.1016/j.ijchp.2024.100445

Yanjuan Li , Mengyao He , Zhenzhen Wang , Stefan G. Hofmann , Xinghua Liu

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Abstract

Objective

We aimed to investigate whether distress tolerance mediated the effects of mindfulness-based intervention (MBI) on anxiety and depression with two randomized controlled studies.

Method

In Study 1, 374 participants with at least moderate emotional distress were randomized to an intervention group (N = 174) and a waitlist control group (N = 173). Mindfulness, distress tolerance, anxiety, and depression were measured at the pre-test, week 3, week 5, and post-test. In Study 2, 170 participants with emotional disorders were randomized to an intervention group (N = 86) and a control group (N = 84). The same variables were assessed at pre-test, weekly during the intervention, and post-test.

Results

In both studies, linear mixed effect models showed that compared to the control group, mindfulness, distress tolerance, anxiety, and depression significantly improved in the intervention group. Parallel process latent growth curve models showed that changes in distress tolerance mediated the effects of the MBI on changes in anxiety and depression. Random-intercept cross-lagged panel models found that distress tolerance temporally preceded depression, but not anxiety.

Conclusions

Distress tolerance is a potential mechanism underlying MBIs. Interventions targeting distress tolerance could be embedded in MBIs to enhance the intervention effects for emotional distress.

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压力耐受性是以正念为基础的焦虑和抑郁干预的中介：来自两项随机对照试验的证据

方法在研究 1 中，374 名至少有中度情绪困扰的参与者被随机分配到干预组（174 人）和候补对照组（173 人）。分别在测试前、测试第 3 周、测试第 5 周和测试后对正念、痛苦容忍度、焦虑和抑郁进行了测量。在研究 2 中，170 名患有情绪障碍的参与者被随机分为干预组（86 人）和对照组（84 人）。结果在这两项研究中，线性混合效应模型显示，与对照组相比，干预组的正念、苦恼容忍度、焦虑和抑郁都有显著改善。平行过程潜增长曲线模型显示，困扰容忍度的变化介导了 MBI 对焦虑和抑郁变化的影响。随机截距交叉滞后面板模型发现，困扰容忍度在时间上先于抑郁，而不是先于焦虑。压力耐受性是 MBI 的潜在机制，以压力耐受性为目标的干预措施可以嵌入 MBI 中，以增强对情绪困扰的干预效果。

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来源期刊

International Journal of Clinical and Health Psychology PSYCHOLOGY, CLINICAL-

CiteScore

10.70

自引率

5.70%

发文量

审稿时长

33 days

期刊介绍： The International Journal of Clinical and Health Psychology is dedicated to publishing manuscripts with a strong emphasis on both basic and applied research, encompassing experimental, clinical, and theoretical contributions that advance the fields of Clinical and Health Psychology. With a focus on four core domains—clinical psychology and psychotherapy, psychopathology, health psychology, and clinical neurosciences—the IJCHP seeks to provide a comprehensive platform for scholarly discourse and innovation. The journal accepts Original Articles (empirical studies) and Review Articles. Manuscripts submitted to IJCHP should be original and not previously published or under consideration elsewhere. All signing authors must unanimously agree on the submitted version of the manuscript. By submitting their work, authors agree to transfer their copyrights to the Journal for the duration of the editorial process.