Mediators of change in online mindfulness-based cognitive therapy: A secondary analysis of a randomized trial of mindful mood balance.
Sona Dimidjian, Robert Gallop, Joseph J. Lévy, Arne Beck, Zindel V. Segal
Journal of Consulting and Clinical Psychology July 17, 2023 DOI: 10.1037/ccp0000825 (opens in new tab) via OpenAlex
Summary
AI-generated from the abstractThe Mindful Mood Balance (MMB) program, a digitally delivered version of mindfulness-based cognitive therapy, combined with usual depression care, produced greater improvements in decentering, mindfulness, and rumination than usual care alone among adults with residual depressive symptoms. Changes in these three processes each predicted a lower likelihood of depressive relapse. The findings indicate that the program's benefits operate through the same mechanisms as in-person mindfulness-based cognitive therapy and that these mechanisms can be engaged through digital delivery.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Population | Predominantly White, female participants with residual depressive symptoms |
| Intervention | Mindful Mood Balance (MMB) program |
| Topics | Anxiety Meditation |
| Keywords | Rumination Mood Psycinfo Clinical psychology |
| Citations | 14 |
| Key finding | The MMB program plus usual care led to significantly greater improvements in decentering, mindfulness, and rumination than usual care alone, and changes in these targets each mediated subsequent depressive relapse. |
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).