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Psychological Processes and Symptom Outcomes in Mindfulness-Based Stress Reduction for Cancer Survivors: A Pilot Study.

Kelly Chinh, Catherine E Mosher, Linda F Brown, Kathleen A Beck-Coon, Kurt Kroenke, Shelley A Johns

Mindfulness January 14, 2020 DOI: 10.1007/s12671-019-01299-0 (opens in new tab)

Study at a glance

AI-extracted from the abstract
Characteristics Secondary analysis of a randomized controlled trial Pilot study Peer reviewed
Sample size 35
Population Persistently fatigued cancer survivors (94% female, 77% breast cancer survivors)
Intervention Mindfulness-based stress reduction (MBSR)
Duration Pre-intervention, post-intervention, and 1-month follow-up
Topics Meditation
Keywords Cancer Fatigue Psychological flexibility Mindfulness-based stress reduction Self-compassion
Key findings MBSR increased mindfulness facets (observing, acting with awareness, nonjudging) and self-compassion relative to waitlist. None of the psychological processes predicted change in fatigue interference; however, increased nonjudging was associated with decreased sleep disturbance (β = -.39) and increased acting with awareness with decreased emotional distress (β = -.36). Self-compassion did not predict symptom change.

Abstract

Objectives: Growing evidence supports the efficacy of mindfulness-based interventions for symptoms in cancer survivors. Identifying theory-based psychological processes underlying their effects on symptoms would inform research to enhance their efficacy and cost-effectiveness. We conducted secondary analyses examining the effect of mindfulness-based stress reduction (MBSR) for cancer-related fatigue on mindfulness facets, self-compassion, and psychological inflexibility. We also examined whether changes in these processes were associated with the symptom outcomes of fatigue interference, sleep disturbance, and emotional distress.

Methods: Thirty-five persistently fatigued cancer survivors (94% female, 77% breast cancer survivors) were randomized to either MBSR for cancer-related fatigue or a waitlist control (WC) condition. Self-report measures were administered at pre-intervention, post-intervention, and 1-month follow-up. Then the WC group received MBSR and completed a post-intervention follow-up.

Results: Linear mixed modeling analyses of the first three time points showed steady increases over time for certain mindfulness facets (observing, acting with awareness, and nonjudging) and self-compassion in favor of the MBSR group. When analyzing pre- and post-intervention data across study conditions, none of the psychological processes predicted change in fatigue interference. However, increased nonjudging was associated with decreased sleep disturbance (β = -.39, p = .003), and increased acting with awareness was associated with decreased emotional distress (β = -.36, p = .003). Self-compassion did not predict change in symptom outcomes.

Conclusions: Results point to specific psychological processes that may be targeted to maximize the efficacy of future MBSR interventions for cancer survivors.

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