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Gepubliceerd in: Mindfulness 12/2019

24-10-2019 | ORIGINAL PAPER

Testing a Moderated Mediation Model of MBCT’s Effects for Psoriasis Patients

Auteurs: Alan Maddock, David Hevey, Paul D’Alton, Brian Kirby

Gepubliceerd in: Mindfulness | Uitgave 12/2019

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Abstract

Objectives

The evidence base supporting the positive impact of mindfulness-based programs (MBPs) has increased over the last decade. Methodological limitations in this literature, however, limit the extent to which it can be said that compelling evidence of MBP efficacy exists. The mechanisms by which MBPs effect change are also unclear. This study attempts to identify these mechanisms.

Methods

This study used data from an RCT (N = 101) investigating the impact of a mindfulness-based cognitive therapy (MBCT) program on self-reported psoriasis, depression, anxiety, and psychological wellbeing. We tested moderated mediation effects of changes in attention regulation, self-compassion, acceptance, mindfulness, non-attachment, aversion, rumination and worry scores post intervention on anxiety, depression, and psychological wellbeing. Total, direct and indirect effects were estimated by bootstrapped moderated mediation analyses providing 95% bias-corrected bootstrap confidence intervals.

Results

The results indicated that changes in self-compassion were associated with changes in anxiety and attention regulation with psychological wellbeing when moderated by group allocation post intervention. Decreases in aversion were also found to be significantly associated with improved psychological wellbeing when mediated by reduced rumination, and reduced anxiety when mediated by decreases in worry. Increased mindfulness was found to be significantly associated with reduced anxiety when mediated by reduced worry.

Conclusion

This study provides some initial evidence on what the mechanisms of mindfulness might be.
Literatuur
go back to reference Arch, J. J., & Landy, L. N. (2015). Mindfulness and emotional benefits. In K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research and practice (pp. 208–224). New York: Guilford Press. Arch, J. J., & Landy, L. N. (2015). Mindfulness and emotional benefits. In K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research and practice (pp. 208–224). New York: Guilford Press.
go back to reference Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory-II. San Antonio: Psychological Corporation. Beck, A. T., Steer, R. A., & Brown, G. K. (1996). Manual for the Beck depression inventory-II. San Antonio: Psychological Corporation.
go back to reference Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., ... & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: a revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676–688. Bond, F. W., Hayes, S. C., Baer, R. A., Carpenter, K. M., Guenole, N., Orcutt, H. K., ... & Zettle, R. D. (2011). Preliminary psychometric properties of the Acceptance and Action Questionnaire–II: a revised measure of psychological inflexibility and experiential avoidance. Behavior Therapy, 42(4), 676–688.
go back to reference Borkovec, T. D. (1994). The nature, functions, and origins of worry. In G. C. L. Davey & F. Tallis (Eds.), Wiley Series in Clinical Psychology. Worrying: Perspectives on theory, assessment and treatment (pp. 5–34). Oxford: John Wiley & Sons. Borkovec, T. D. (1994). The nature, functions, and origins of worry. In G. C. L. Davey & F. Tallis (Eds.), Wiley Series in Clinical Psychology. Worrying: Perspectives on theory, assessment and treatment (pp. 5–34). Oxford: John Wiley & Sons.
go back to reference Brown, K. W. (2015). Mindfulness training to enhance positive functioning. In K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 311–325). New York: Guilford Press. Brown, K. W. (2015). Mindfulness training to enhance positive functioning. In K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 311–325). New York: Guilford Press.
go back to reference Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848.CrossRefPubMed Brown, K. W., & Ryan, R. M. (2003). The benefits of being present: mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology, 84(4), 822–848.CrossRefPubMed
go back to reference Cameron, I. M., Cardy, A., Crawford, J. R., du Toit, S. W., Hay, S., Lawton, K., … & Reid, I. C. (2011). Measuring depression severity in general practice: discriminatory performance of the PHQ-9, HADS-D, and BDI-II. British Journal of General Practice, 61(588), 419–426. https://doi.org/10.3399/bjgp11X583209 CrossRef Cameron, I. M., Cardy, A., Crawford, J. R., du Toit, S. W., Hay, S., Lawton, K., … & Reid, I. C. (2011). Measuring depression severity in general practice: discriminatory performance of the PHQ-9, HADS-D, and BDI-II. British Journal of General Practice, 61(588), 419–426. https://​doi.​org/​10.​3399/​bjgp11X583209 CrossRef
go back to reference Cardaciotto, L., Herbert, J. D., Forman, E. M., Moitra, E., & Farrow, V. (2008). The assessment of present-moment awareness and acceptance: the Philadelphia mindfulness scale. Assessment, 15(2), 204–223.CrossRefPubMed Cardaciotto, L., Herbert, J. D., Forman, E. M., Moitra, E., & Farrow, V. (2008). The assessment of present-moment awareness and acceptance: the Philadelphia mindfulness scale. Assessment, 15(2), 204–223.CrossRefPubMed
go back to reference Carlson, L. E. (2015). Mindfulness-based interventions for physical conditions: A selective review. In K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 405–425). New York: Guilford Press. Carlson, L. E. (2015). Mindfulness-based interventions for physical conditions: A selective review. In K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 405–425). New York: Guilford Press.
go back to reference Chadwick, P., Hember, M., Symes, J., Peters, E., Kuipers, E., & Dagnan, D. (2008). Responding mindfully to unpleasant thoughts and images: reliability and validity of the Southampton mindfulness questionnaire (SMQ). British Journal of Clinical Psychology, 47(4), 451–455.CrossRef Chadwick, P., Hember, M., Symes, J., Peters, E., Kuipers, E., & Dagnan, D. (2008). Responding mindfully to unpleasant thoughts and images: reliability and validity of the Southampton mindfulness questionnaire (SMQ). British Journal of Clinical Psychology, 47(4), 451–455.CrossRef
go back to reference Fleming, P., Bai, J. W., Pratt, M., Sibbald, C., Lynde, C., & Gulliver, W. P. (2017). The prevalence of anxiety in patients with psoriasis: a systematic review of observational studies and clinical trials. Journal of the European Academy of Dermatology and Venereology, 31(5), 798–807. https://doi.org/10.1111/jdv.13891.CrossRefPubMed Fleming, P., Bai, J. W., Pratt, M., Sibbald, C., Lynde, C., & Gulliver, W. P. (2017). The prevalence of anxiety in patients with psoriasis: a systematic review of observational studies and clinical trials. Journal of the European Academy of Dermatology and Venereology, 31(5), 798–807. https://​doi.​org/​10.​1111/​jdv.​13891.CrossRefPubMed
go back to reference Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2002). Distinct and overlapping features of rumination and worry: the relationship of cognitive production to negative affective states. Cognitive Therapy and Research, 26(2), 179–188.CrossRef Fresco, D. M., Frankel, A. N., Mennin, D. S., Turk, C. L., & Heimberg, R. G. (2002). Distinct and overlapping features of rumination and worry: the relationship of cognitive production to negative affective states. Cognitive Therapy and Research, 26(2), 179–188.CrossRef
go back to reference Fresco, D. M., Moore, M. T., van Dulmen, M. H., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. G. (2007). Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behavior Therapy, 38(3), 234–246.CrossRefPubMed Fresco, D. M., Moore, M. T., van Dulmen, M. H., Segal, Z. V., Ma, S. H., Teasdale, J. D., & Williams, J. M. G. (2007). Initial psychometric properties of the experiences questionnaire: validation of a self-report measure of decentering. Behavior Therapy, 38(3), 234–246.CrossRefPubMed
go back to reference Furr, R. M. (2017). Psychometrics: An introduction (3rd ed.). Thousand Oaks: SAGE Publications. Furr, R. M. (2017). Psychometrics: An introduction (3rd ed.). Thousand Oaks: SAGE Publications.
go back to reference Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual foundations. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 3–24). New York: Guilford Press. Gross, J. J., & Thompson, R. A. (2007). Emotion regulation: Conceptual foundations. In J. J. Gross (Ed.), Handbook of emotion regulation (pp. 3–24). New York: Guilford Press.
go back to reference Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guildford. Hayes, A. F. (2018). Introduction to mediation, moderation, and conditional process analysis: A regression-based approach. New York: Guildford.
go back to reference Hayes-Skelton, S. A., & Wadsworth, L. P. (2015). Mindfulness in the treatment of anxiety. In K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 367–386). New York: Guilford Press. Hayes-Skelton, S. A., & Wadsworth, L. P. (2015). Mindfulness in the treatment of anxiety. In K. W. Brown, J. D. Creswell, & R. M. Ryan (Eds.), Handbook of mindfulness: Theory, research, and practice (pp. 367–386). New York: Guilford Press.
go back to reference Irish Skin Foundation. (2015). The burden of psoriasis epidemiology, quality of life, co-morbidities and treatment goals. Galway: Novartis & J.E. Cairnes School of Business and Economics. Irish Skin Foundation. (2015). The burden of psoriasis epidemiology, quality of life, co-morbidities and treatment goals. Galway: Novartis & J.E. Cairnes School of Business and Economics.
go back to reference Kelly-Sell, M., & Gudjonsson, J. E. (2017). Overview of psoriasis. In J. Wu, S. Feldman, & M. Lebwohl (Eds.), Therapy for severe psoriasis (pp. 1–16). Philadelphia: Elsevier. Kelly-Sell, M., & Gudjonsson, J. E. (2017). Overview of psoriasis. In J. Wu, S. Feldman, & M. Lebwohl (Eds.), Therapy for severe psoriasis (pp. 1–16). Philadelphia: Elsevier.
go back to reference Lazarus, R. S., & Folkman, S. (1984). Coping and adaptation. In W. D. Gentry (Ed.), The handbook of behavioral medicine (pp. 282–325). New York: Guilford. Lazarus, R. S., & Folkman, S. (1984). Coping and adaptation. In W. D. Gentry (Ed.), The handbook of behavioral medicine (pp. 282–325). New York: Guilford.
go back to reference Long, J., Briggs, M., & Astin, F. (2017). Overview of systematic reviews of mindfulness meditation-based interventions for people with long-term conditions. Advances in Mind-Body Medicine, 31(4), 26–36.PubMed Long, J., Briggs, M., & Astin, F. (2017). Overview of systematic reviews of mindfulness meditation-based interventions for people with long-term conditions. Advances in Mind-Body Medicine, 31(4), 26–36.PubMed
go back to reference Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28(6), 487–495.CrossRefPubMed Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec, T. D. (1990). Development and validation of the Penn State Worry Questionnaire. Behaviour Research and Therapy, 28(6), 487–495.CrossRefPubMed
go back to reference Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250.CrossRef Neff, K. D. (2003). The development and validation of a scale to measure self-compassion. Self and Identity, 2(3), 223–250.CrossRef
go back to reference Neff, K. D., & Dahm, K. A. (2015). Self-compassion: What it is, what it does, and how it relates to mindfulness. In M. Robinson, B. Meier, & B. Ostafin (Eds.), Mindfulness and self-regulation (pp. 121–137). New York: Springer. Neff, K. D., & Dahm, K. A. (2015). Self-compassion: What it is, what it does, and how it relates to mindfulness. In M. Robinson, B. Meier, & B. Ostafin (Eds.), Mindfulness and self-regulation (pp. 121–137). New York: Springer.
go back to reference Orzech, K., Shapiro, S. L., & Brown, K. (2009). Intensive mindfulness training-related changes in cognitive and emotional experience. Journal of Positive Psychology, 4(3), 212–222.CrossRef Orzech, K., Shapiro, S. L., & Brown, K. (2009). Intensive mindfulness training-related changes in cognitive and emotional experience. Journal of Positive Psychology, 4(3), 212–222.CrossRef
go back to reference Sahdra, B. K., Shaver, P. R., & Brown, K. W. (2010). A scale to measure nonattachment: a Buddhist complement to Western research on attachment and adaptive functioning. Journal of Personality Assessment, 92(2), 116–127.CrossRefPubMed Sahdra, B. K., Shaver, P. R., & Brown, K. W. (2010). A scale to measure nonattachment: a Buddhist complement to Western research on attachment and adaptive functioning. Journal of Personality Assessment, 92(2), 116–127.CrossRefPubMed
go back to reference Segal, Z. V., Williams, J. M., & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for depression: A new approach to preventing relapse. New York: Guilford Press. Segal, Z. V., Williams, J. M., & Teasdale, J. D. (2002). Mindfulness-Based Cognitive Therapy for depression: A new approach to preventing relapse. New York: Guilford Press.
go back to reference Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five-factor model of personality: distinguishing rumination from reflection. Journal of Personality and Social Psychology, 76(2), 284–304.CrossRefPubMed Trapnell, P. D., & Campbell, J. D. (1999). Private self-consciousness and the five-factor model of personality: distinguishing rumination from reflection. Journal of Personality and Social Psychology, 76(2), 284–304.CrossRefPubMed
go back to reference World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. Geneva: Author. World Health Organization. (2017). Depression and other common mental disorders: Global health estimates. Geneva: Author.
go back to reference Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.CrossRefPubMed Zigmond, A. S., & Snaith, R. P. (1983). The hospital anxiety and depression scale. Acta Psychiatrica Scandinavica, 67(6), 361–370.CrossRefPubMed
Metagegevens
Titel
Testing a Moderated Mediation Model of MBCT’s Effects for Psoriasis Patients
Auteurs
Alan Maddock
David Hevey
Paul D’Alton
Brian Kirby
Publicatiedatum
24-10-2019
Uitgeverij
Springer US
Gepubliceerd in
Mindfulness / Uitgave 12/2019
Print ISSN: 1868-8527
Elektronisch ISSN: 1868-8535
DOI
https://doi.org/10.1007/s12671-019-01249-w

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