Mediators of change in online mindfulness-based cognitive therapy: A secondary analysis of a randomized trial of mindful mood balance.

IF 4.5 1区心理学 Q1 PSYCHOLOGY, CLINICAL Journal of consulting and clinical psychology Pub Date : 2023-08-01 DOI:10.1037/ccp0000825

Sona Dimidjian, Robert Gallop, Joseph Levy, Arne Beck, Zindel V Segal

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Abstract

Objective: Digital delivery of mindfulness-based cognitive therapy through the Mindful Mood Balance (MMB) program is clinically effective (Segal et al., 2020); however, the mechanisms through which this program delivers its benefits have not been established.

Method: This study investigates the differential impact of the MMB program paired with usual depression care (UDC) compared to UDC alone on the putative targets of self-reported mindfulness, decentering, and rumination and the extent to which change in these targets mediates subsequent depressive relapse among a sample of predominantly White, female participants, with residual depressive symptoms.

Results: The MMB program relative to UDC was associated with a significantly greater rate of change in decentering (t = 4.94, p < .0001, d = 0.46), mindfulness (t = 6.04, p < .0001, d = 0.56), and rumination (t = 3.82, p < .0001, d = 0.36). Subsequent depressive relapse also was mediated by prior change in these putative targets, with a significant natural indirect effect for decentering, χ2(1) = 7.25, p < .008, OR = 0.57; mindfulness, χ2(1) = 9.99, p < .002, OR = 0.50; and rumination, χ2(1) = 12.95, p < .001, OR = 0.35.

Conclusions: These findings suggest the mechanisms of MMB are consistent with the conceptual model for mindfulness-based cognitive therapy and depressive relapse risk and that such processes can be modified through digital delivery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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在线正念认知疗法变化的中介:正念情绪平衡随机试验的二次分析。

目的:通过正念情绪平衡(MMB)项目的正念认知疗法的数字化交付在临床上是有效的(Segal等，2020);然而，这一方案的效益机制尚未建立。方法:本研究调查了MMB计划与常规抑郁护理(UDC)相比，UDC单独对自我报告的正念、去中心化和反刍的假设目标的不同影响，以及这些目标的变化在多大程度上介导了随后的抑郁复发，主要是白人女性参与者，残余抑郁症状。结果:相对于UDC而言，MMB计划与分散性(t = 4.94, p < 0.0001, d = 0.46)、正念(t = 6.04, p < 0.0001, d = 0.56)和反刍(t = 3.82, p < 0.0001, d = 0.36)的变化率显著更高相关。随后的抑郁复发也可由先前这些假定靶点的改变介导，对去中心化有显著的自然间接影响，χ2(1) = 7.25, p < 0.008, OR = 0.57;正念，χ2(1) = 9.99, p < 0.002, OR = 0.50;反刍，χ2(1) = 12.95, p < .001, OR = 0.35。结论:这些发现表明MMB的机制与基于正念的认知治疗和抑郁复发风险的概念模型一致，并且这些过程可以通过数字传输进行修改。(PsycInfo数据库记录(c) 2023 APA，版权所有)。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of consulting and clinical psychology PSYCHOLOGY, CLINICAL-

CiteScore

9.00

自引率

3.40%

发文量

期刊介绍： The Journal of Consulting and Clinical Psychology® (JCCP) publishes original contributions on the following topics: the development, validity, and use of techniques of diagnosis and treatment of disordered behaviorstudies of a variety of populations that have clinical interest, including but not limited to medical patients, ethnic minorities, persons with serious mental illness, and community samplesstudies that have a cross-cultural or demographic focus and are of interest for treating behavior disordersstudies of personality and of its assessment and development where these have a clear bearing on problems of clinical dysfunction and treatmentstudies of gender, ethnicity, or sexual orientation that have a clear bearing on diagnosis, assessment, and treatmentstudies of psychosocial aspects of health behaviors. Studies that focus on populations that fall anywhere within the lifespan are considered. JCCP welcomes submissions on treatment and prevention in all areas of clinical and clinical–health psychology and especially on topics that appeal to a broad clinical–scientist and practitioner audience. JCCP encourages the submission of theory–based interventions, studies that investigate mechanisms of change, and studies of the effectiveness of treatments in real-world settings. JCCP recommends that authors of clinical trials pre-register their studies with an appropriate clinical trial registry (e.g., ClinicalTrials.gov, ClinicalTrialsRegister.eu) though both registered and unregistered trials will continue to be considered at this time.