Examining efficacy and potential mechanisms of mindfulness-based cognitive therapy for anxiety and stress reduction among college students in a cluster-randomized controlled trial

IF 5.3 1区 心理学 Q1 PSYCHOLOGY, CLINICAL International Journal of Clinical and Health Psychology Pub Date : 2024-10-01 DOI:10.1016/j.ijchp.2024.100514
Oksana K. Ellison , Lauren E. Bullard , Gloria K. Lee , Spiridoula Vazou , Karin A. Pfeiffer , Shelby E. Baez , Matthew B. Pontifex
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Abstract

The pervasiveness of anxiety and stress among college students necessitates the investigation of potential alternative and accessible interventions which can be implemented into existing curricular and student-support programming to improve students' mental health. Mindfulness based cognitive therapy (MBCT) smartphone applications have shown promising outcomes in alleviating anxiety and stress. However, it is essential to gain insight into the feasibility and efficacy of such an interventional approach in a collegiate population, as well as explore potential underlying mechanisms, which could be better targeted to enhance the efficacy of future interventions for promoting mental health and well-being. The aims for this study were (1) to assess the efficacy of a 4-week MBCT intervention using the Sanvello smartphone application in reducing trait-level anxiety and chronic stress in college-aged young adults (n = 150) compared to a positive control group (n = 139), and (2) to examine potential mediators of this effect. Participants completed assessments of trait anxiety, chronic stress, cognitive reappraisal, cognitive refocusing, distractive refocusing, and negative automatic thoughts at pretest and following 4 weeks of the interventions. Analysis of primary outcomes revealed greater reductions in trait anxiety and chronic stress for the MBCT group, relative to the positive control group with small to moderate effect sizes. The anxiolytic and stress-reducing effects of the MBCT intervention were observed to be mediated by changes in negative automatic thoughts but not by changes in cognitive reappraisal, constructive refocusing, or distractive refocusing. Given the efficacy of the Sanvello smartphone application and the overwhelmingly strong assessments of the appropriateness and feasibility of it use; student support initiatives may be well served by adopting such a platform within the context of first-line treatment and prevention of high anxiety and chronic stress within first year college students. Registered at ClinicalTrials.gov [number NCT06019299].
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通过分组随机对照试验,研究正念认知疗法对大学生减轻焦虑和压力的疗效和潜在机制
大学生普遍存在焦虑和压力,因此有必要研究潜在的替代性干预措施,并将其纳入现有的课程和学生支持计划,以改善学生的心理健康。基于正念认知疗法(MBCT)的智能手机应用程序在缓解焦虑和压力方面取得了可喜的成果。然而,我们有必要深入了解这种干预方法在大学生群体中的可行性和有效性,并探索潜在的内在机制,以便更好地提高未来干预措施对促进心理健康和幸福感的功效。本研究的目的是:(1) 评估使用 Sanvello 智能手机应用程序进行的为期 4 周的 MBCT 干预疗法与积极对照组(139 人)相比,在降低大学生群体(150 人)的特质焦虑水平和慢性压力方面的效果;(2) 研究这种效果的潜在中介因素。参与者在干预前和干预 4 周后完成了对特质焦虑、慢性压力、认知重估、认知重新聚焦、分散注意力重新聚焦和消极自动想法的评估。对主要结果的分析表明,与积极对照组相比,MBCT 组在特质焦虑和慢性压力方面的减少幅度更大,其效应大小为小到中等。据观察,MBCT 干预的抗焦虑和减压效果是由消极的自动想法的变化所介导的,而不是由认知重新评估、建设性重新聚焦或分散注意力重新聚焦的变化所介导的。鉴于 Sanvello 智能手机应用程序的功效,以及对其使用适当性和可行性的压倒性评价;在一线治疗和预防大学一年级学生的高度焦虑和慢性压力的背景下,采用这样的平台可能会很好地为学生支持计划服务。已在 ClinicalTrials.gov 注册[编号 NCT06019299]。
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来源期刊
CiteScore
10.70
自引率
5.70%
发文量
38
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.
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