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The Mechanisms of Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy for Cancer Patients and Survivors: A Systematic Review.

Lauren M Carney, Crystal L Park, Pooja Hingorany

Psychology of Consciousness Theory Research and Practice June 15, 2023 DOI: 10.1037/cns0000362 (opens in new tab)

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AI-extracted from the abstract
Characteristics Systematic review Peer reviewed
Population Adult cancer patients and survivors
Interventions Mindfulness-based stress reduction (MBSR) mindfulness-based cognitive therapy (MBCT)
Topics Meditation
Keywords Cancer Mediator Psycho-oncology Systematic review
Key findings Only 13 of 156 experimental or quasi-experimental studies of mindfulness-based stress reduction or mindfulness-based cognitive therapy in adult cancer patients and survivors longitudinally tested mediators. Evidence on mindfulness as a mediator was inconclusive, most other mediators were tested in only one study, and most studies lacked strong active control groups. The authors argue that these limitations, along with inconsistent conceptualizations of mindfulness, preclude strong conclusions and that mediation should continue to be tested in this population.

Abstract

While many systematic reviews have focused on relationships between mindfulness-based interventions (MBIs) and myriad outcomes, no systematic review has examined the mechanisms through which MBIs affect outcomes in the context of cancer. A systematic review was conducted of experimental or quasi-experimental studies that longitudinally examined potential mechanisms of the effects of either mindfulness-based stress reduction (MBSR) or mindfulness-based cognitive therapy (MBCT) interventions with adult cancer patients and survivors. Searches were conducted in Pubmed, APA PsycInfo, Cumulated Index to Nursing and Allied Health Literature, Cochrane, and Scopus databases up to May 2022. The results of included studies were narratively synthesized and studies were graded for quality using a rubric tailored to mediational intervention studies. Of 156 experimental or quasi-experimental studies that implemented either MBSR or MBCT interventions with adult cancer patients and survivors, only 13 longitudinally tested for mediators (e.g., changes in mindfulness, rumination, and self-compassion) of intervention effects. Most studies lacked a strong, active control group and most (10/13) were of medium quality. Results on mindfulness as a mediator of intervention effects were inconclusive, and many other mediators were only tested within a single study. Methodological limitations, including lack of strong comparison groups and theoretical frameworks and inconsistent conceptualizations of mindfulness, preclude drawing strong conclusions from the current body of evidence. MBIs may operate differently for cancer patients/survivors, highlighting the importance of continuing to test for mediation within this population.

Comparable studies

Other systematic reviews and meta-analyses on meditation, most cited first.

Study Year Design Participants
Meditation Programs for Psychological Stress and Well-being Diverse adult clinical populations 2014 Meta-analysis n = 3,515
Mindfulness-Based Stress Reduction for Stress Management in Healthy People: A Review and Meta-Analysis Healthy subjects 2009 Systematic review and meta-analysis
The psychological effects of meditation: A meta-analysis. Nonclinical groups of adult meditators 2012 Meta-analysis n = 163
Efficacy of Mindfulness-Based Cognitive Therapy in Prevention of Depressive Relapse Adults with recurrent depression in full or partial remission 2016 Meta-analysis of individual patient data from randomized controlled trials n = 1,258
Mindfulness‐Based Stress Reduction and Mindfulness‐Based Cognitive Therapy – a systematic review of randomized controlled trials 2011 Systematic review

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