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).
Comparable studies
Other randomized controlled trials on meditation, most cited first.
| Study | Year | Design | Participants |
|---|---|---|---|
| Alterations in Brain and Immune Function Produced by Mindfulness Meditation Healthy employees in a work environment | 2003 | Randomized controlled trial | n = 41 |
| Prevention of relapse/recurrence in major depression by mindfulness-based cognitive therapy. Recovered recurrently depressed patients | 2000 | Randomized controlled trial | n = 145 |
| Open hearts build lives: Positive emotions, induced through loving-kindness meditation, build consequential personal resources. Working adults | 2008 | Randomized controlled trial | n = 139 |
| Short-term meditation training improves attention and self-regulation Undergraduate Chinese students | 2007 | Randomized controlled trial | n = 40 |
| Mindfulness-Based Cognitive Therapy for Depression: Replication and Exploration of Differential Relapse Prevention Effects. Recovered recurrently depressed patients | 2004 | Randomized controlled trial | n = 73 |
Citations in the library
Cited by 10
- Is a brief mindfulness ecological momentary intervention more efficacious than a self-monitoring app for social anxiety disorder? A randomized controlled trial. Journal of Anxiety Disorders June 1, 2024
- Psychological Mediators of Reduced Distress: Preregistered Analyses from a Randomized Controlled Trial of a Smartphone-Based Well-Being Training. Clinical Psychological Science 2025
- Investigating change in the ability to decentre and depressive symptomatology over the course of a six-month mindfulness-based intervention in patients with persistent depression. Psychiatry Research November 1, 2024
- Outcomes of Mindful Mood Balance for Moms, online mindfulness-based cognitive therapy for perinatal depressive relapse prevention in the USA: a two-arm, single-blind, pragmatic randomised clinical trial The Lancet Public Health October 20, 2026
- Synchronous Online Group MBCT vs. Guided Asynchronous Online MBCT for Mild to Moderate Depression: A Randomized Clinical Trial Mindfulness March 1, 2026
and 5 more in the library