J Richard T Korecki, Patricia A Ganz, Ann H Partridge, Antonio C Wolff, Laura Petersen, Catherine M Crespi, Julienne E Bower
{"title":"对年轻乳腺癌幸存者进行正念干预的中介因素：对抑郁症状的影响","authors":"J Richard T Korecki, Patricia A Ganz, Ann H Partridge, Antonio C Wolff, Laura Petersen, Catherine M Crespi, Julienne E Bower","doi":"10.1097/PSY.0000000000001340","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Depression is associated with poor outcomes in breast cancer patients, with higher prevalence among younger women. Although mindfulness-based interventions (MBIs) have demonstrated therapeutic effects, the mechanisms of intervention effects are poorly understood. We investigated whether rumination, self-kindness, intrusive thoughts about cancer, cancer-related worry, or a sense of meaning and peace mediated the intervention effects of an MBI, Mindful Awareness Practices (MAPs), on depressive symptoms. Additionally, we explored the same variables as mediators of a psychoeducation program, Survivorship Education (SE).</p><p><strong>Methods: </strong>Women diagnosed with stage 0-III breast cancer at age <50 years were randomized to 6 weeks of MAPs ( n = 85), SE ( n = 81), or wait-list control (WLC; n = 81). During preintervention, postintervention, and 6-month follow-up (FU), we assessed depressive symptoms, rumination, self-kindness, intrusive thoughts, worry, and meaning and peace.</p><p><strong>Results: </strong>MAPs and SE significantly reduced depressive symptoms at postintervention, and reductions remained through 6-month FU for MAPs. Models revealed that reductions in rumination ( β = -0.68, 95% confidence interval [CI] = -1.64 to -0.07) and intrusive thoughts ( β = 1.17, 95% CI = -2.17 to -0.37) and improvements in self-kindness ( β = -1.09, 95% CI = -2.37 to -0.28) and meaning and peace ( β = -1.09, 95% CI = -3.16 to -0.56) mediated MAPs' effects at all time points. Reductions in worry ( β = -1.34, 95% CI = -2.47 to -0.45]) mediated effects at postintervention only. Worry and intrusive thoughts mediated SE effects at postintervention and 6-month FU, respectively.</p><p><strong>Conclusions: </strong>Findings identified depression-relevant mediators of MAPs' effects, expanding the understanding of MBI mechanisms. Results highlight pathways that could be leveraged to optimize intervention outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03025139 .</p>","PeriodicalId":20918,"journal":{"name":"Psychosomatic Medicine","volume":null,"pages":null},"PeriodicalIF":2.9000,"publicationDate":"2024-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Mediators of a Mindfulness-Based Intervention for Younger Breast Cancer Survivors: Effects on Depressive Symptoms.\",\"authors\":\"J Richard T Korecki, Patricia A Ganz, Ann H Partridge, Antonio C Wolff, Laura Petersen, Catherine M Crespi, Julienne E Bower\",\"doi\":\"10.1097/PSY.0000000000001340\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Objective: </strong>Depression is associated with poor outcomes in breast cancer patients, with higher prevalence among younger women. Although mindfulness-based interventions (MBIs) have demonstrated therapeutic effects, the mechanisms of intervention effects are poorly understood. We investigated whether rumination, self-kindness, intrusive thoughts about cancer, cancer-related worry, or a sense of meaning and peace mediated the intervention effects of an MBI, Mindful Awareness Practices (MAPs), on depressive symptoms. Additionally, we explored the same variables as mediators of a psychoeducation program, Survivorship Education (SE).</p><p><strong>Methods: </strong>Women diagnosed with stage 0-III breast cancer at age <50 years were randomized to 6 weeks of MAPs ( n = 85), SE ( n = 81), or wait-list control (WLC; n = 81). During preintervention, postintervention, and 6-month follow-up (FU), we assessed depressive symptoms, rumination, self-kindness, intrusive thoughts, worry, and meaning and peace.</p><p><strong>Results: </strong>MAPs and SE significantly reduced depressive symptoms at postintervention, and reductions remained through 6-month FU for MAPs. Models revealed that reductions in rumination ( β = -0.68, 95% confidence interval [CI] = -1.64 to -0.07) and intrusive thoughts ( β = 1.17, 95% CI = -2.17 to -0.37) and improvements in self-kindness ( β = -1.09, 95% CI = -2.37 to -0.28) and meaning and peace ( β = -1.09, 95% CI = -3.16 to -0.56) mediated MAPs' effects at all time points. Reductions in worry ( β = -1.34, 95% CI = -2.47 to -0.45]) mediated effects at postintervention only. Worry and intrusive thoughts mediated SE effects at postintervention and 6-month FU, respectively.</p><p><strong>Conclusions: </strong>Findings identified depression-relevant mediators of MAPs' effects, expanding the understanding of MBI mechanisms. Results highlight pathways that could be leveraged to optimize intervention outcomes.</p><p><strong>Trial registration: </strong>ClinicalTrials.gov identifier: NCT03025139 .</p>\",\"PeriodicalId\":20918,\"journal\":{\"name\":\"Psychosomatic Medicine\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2024-10-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Psychosomatic Medicine\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1097/PSY.0000000000001340\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2024/8/10 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Psychosomatic Medicine","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1097/PSY.0000000000001340","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/8/10 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
摘要
目的：抑郁症与乳腺癌患者的不良预后有关，在年轻女性中发病率更高。虽然正念干预（MBIs）已显示出治疗效果，但人们对干预效果的机制却知之甚少。我们研究了反刍、自我亲切感、对癌症的侵入性想法、与癌症相关的担忧或意义与和平是否对正念觉察练习（MAPs）这种正念干预对抑郁症状的干预效果起中介作用。此外，我们还探讨了作为心理教育计划 "幸存者教育"（SE）中介因素的相同变量：年龄小于 50 岁、被诊断为 0-III 期乳腺癌的女性被随机分配到为期 6 周的 MAPs（85 人）、SE（81 人）或候补对照组（81 人）中。在干预前、干预后和6个月的随访（FU）期间，我们对抑郁症状、反刍、自我亲切感、侵入性想法、担忧以及意义与和平进行了评估：结果：MAPs 和 SE 在干预后能明显减轻抑郁症状，MAPs 在 6 个月的随访中仍能减轻抑郁症状。模型显示，在所有时间点，反刍（β = -0.68，95% CI [-1.64，-0.07]）和侵入性想法（β = 1.17，95% CI [-2.17，-0.37]）的减少以及自我亲切感（β = -1.09，95% CI [-2.37，-0.28]）和意义与和平（β = -1.09，95% CI [-3.16，-0.56]）的改善对 MAPs 的效果起到了中介作用。担忧的减少（β = -1.34, 95% CI [-2.47, -0.45]）仅在干预后的效果中起中介作用。担忧和侵入性想法分别对干预后和6个月FU的SE效应起中介作用：研究结果确定了MAPs效应的抑郁相关中介因素，拓展了对MBI机制的理解。研究结果强调了可用于优化干预结果的途径。
Mediators of a Mindfulness-Based Intervention for Younger Breast Cancer Survivors: Effects on Depressive Symptoms.
Objective: Depression is associated with poor outcomes in breast cancer patients, with higher prevalence among younger women. Although mindfulness-based interventions (MBIs) have demonstrated therapeutic effects, the mechanisms of intervention effects are poorly understood. We investigated whether rumination, self-kindness, intrusive thoughts about cancer, cancer-related worry, or a sense of meaning and peace mediated the intervention effects of an MBI, Mindful Awareness Practices (MAPs), on depressive symptoms. Additionally, we explored the same variables as mediators of a psychoeducation program, Survivorship Education (SE).
Methods: Women diagnosed with stage 0-III breast cancer at age <50 years were randomized to 6 weeks of MAPs ( n = 85), SE ( n = 81), or wait-list control (WLC; n = 81). During preintervention, postintervention, and 6-month follow-up (FU), we assessed depressive symptoms, rumination, self-kindness, intrusive thoughts, worry, and meaning and peace.
Results: MAPs and SE significantly reduced depressive symptoms at postintervention, and reductions remained through 6-month FU for MAPs. Models revealed that reductions in rumination ( β = -0.68, 95% confidence interval [CI] = -1.64 to -0.07) and intrusive thoughts ( β = 1.17, 95% CI = -2.17 to -0.37) and improvements in self-kindness ( β = -1.09, 95% CI = -2.37 to -0.28) and meaning and peace ( β = -1.09, 95% CI = -3.16 to -0.56) mediated MAPs' effects at all time points. Reductions in worry ( β = -1.34, 95% CI = -2.47 to -0.45]) mediated effects at postintervention only. Worry and intrusive thoughts mediated SE effects at postintervention and 6-month FU, respectively.
Conclusions: Findings identified depression-relevant mediators of MAPs' effects, expanding the understanding of MBI mechanisms. Results highlight pathways that could be leveraged to optimize intervention outcomes.
期刊介绍：
Psychosomatic Medicine is the official peer-reviewed journal of the American Psychosomatic Society. The journal publishes experimental, clinical, and epidemiological studies on the role of psychological and social factors in the biological and behavioral processes relevant to health and disease. Psychosomatic Medicine is an interdisciplinary peer-reviewed journal devoted to high-quality science on biobehavioral mechanisms, brain-behavior interactions relevant to physical and mental disorders, as well as interventions in clinical and public health settings.
Psychosomatic Medicine was founded in 1939 and publishes interdisciplinary research articles relevant to medicine, psychiatry, psychology, and other health-related disciplines. The print journal is published nine times a year; most articles are published online ahead of print. Supplementary issues may contain reports of conferences at which original research was presented in areas relevant to the psychosomatic and behavioral medicine.
京公网安备 11010802042870号
京ICP备2023020795号-1
分享
求助内容：
应助结果提醒方式：
扫码关注我们
