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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)

Study at a glance

AI-extracted from the abstract
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 Cognitive therapy Randomized controlled trial Cognition Psychotherapist Medline
Citations 14
Key findings 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).

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