Efficacy and mechanisms of internet-delivered MBCT for adjustment disorder during the COVID-19 pandemic: A randomized controlled trial
Paweł Holas, Jan Michał Wardęszkiewicz, Malgorzata Grochowska, Stefan G Hofmann
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial |
|---|---|
| Sample size | 301 |
| Population | Adults meeting ICD-11 criteria for Adjustment Disorder |
| Intervention | Internet-delivered progressive muscle relaxation (iPMR) |
| Duration | 4-week intervention, 1-month follow-up |
| Topics | Meditation |
| Key findings | iMBCT reduced Adjustment Disorder symptoms more than waitlist control and yielded higher remission rates, with cognitive defusion fully mediating effects on depression and anxiety. |
Abstract
Background: Adjustment Disorder (AjD) is a common stress-related condition, yet evidence-based interventions remain scarce. Mindfulness-Based Cognitive Therapy (MBCT) targets transdiagnostic mechanisms such as cognitive fusion and low self-compassion, which may be particularly relevant for AjD.Objective: This randomized controlled trial tested the efficacy of a brief, guided, asynchronous internet-delivered MBCT (iMBCT) for AjD during the COVID-19 pandemic, compared with internet-delivered progressive muscle relaxation (iPMR) and a waitlist control (WLC).Methods: Adults meeting ICD-11 criteria for AjD (N = 301) were randomized to iMBCT, iPMR, or WLC for four weeks. Primary outcomes were changes in AjD symptoms (ADNM-20) and remission rates. Secondary outcomes were changes in depression, anxiety, cognitive fusion, experiential avoidance, and self-compassion. Outcomes were assessed at baseline, post-intervention, and one-month follow-up. Mediation analyses tested cognitive defusion and self-compassion as mechanisms.
Results: iMBCT produced greater reductions in AjD symptoms than WLC (η² = .17) and higher remission rates. Compared with iPMR, iMBCT yielded larger decreases in depression and anxiety. Cognitive defusion fully mediated iMBCT effects on depression and anxiety. Gains were maintained at follow-up.Conclusions: A brief, minimally guided, asynchronous iMBCT is an effective and scalable intervention for AjD, targeting cognitive and self-regulatory mechanisms. Findings support the use of online mindfulness-based programs for stress-related disorders during large-scale crises.
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 |