Does Mindfulness-Based Cognitive Therapy benefit all people with diabetes and comorbid emotional complaints equally? Moderators in the DiaMind trial.
Ivan Nyklíček, Jenny Van Son, Victor J. Pop, Johan Denollet, François Pouwer
Journal of Psychosomatic Research December 2016 DOI: 10.1016/j.jpsychores.2016.10.009 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 139 |
| Population | Outpatients with type 1 or type 2 diabetes and an elevated level of emotional distress |
| Intervention | Mindfulness-Based Cognitive Therapy (MBCT) |
| Duration | Post-intervention and 6-month follow-up |
| Topics | Meditation |
| Keywords | Diabetes Mindfulness-based cognitive therapy Moderator Personality Randomized trial |
| Key findings | Sex, extraversion, and baseline acting with awareness moderated MBCT effectiveness. Women showed larger decreases in anxiety and depression across time (large effects) than men (medium to small effects). The three lowest extraversion quartiles generally showed large symptom decreases, whereas the high extraversion group showed medium (perceived stress) to small (depression) decreases; the authors suggest large dropout in this subgroup may explain the small effect. |
Abstract
Research has shown the effectiveness of mindfulness-based interventions for a variety of emotional problems in different samples, but it is unknown which factors influence this effectiveness. Therefore, the aim of the current study was: which factors (demographic, personality, and baseline levels of mindfulness skills) moderate the effectiveness of Mindfulness-Based Cognitive Therapy (MBCT)? Outpatients with diabetes (type 1 or type 2; N=139) and an elevated level of emotional distress participated in the Diabetes and Mindfulness (DiaMind) trial. They were randomized into MBCT (N=70) or a control group (N=69) that received treatment as usual and that was offered the intervention 6months later. Primary outcomes were anxiety, depressive symptoms, and perceived stress at post-intervention and at 6-month follow-up. Mixed models analyses showed that sex, extraversion, and baseline acting with awareness were significant moderators of effectiveness. In the MBCT group, women showed larger decreases in anxiety and depression across time (large effects) compared to men (medium to small effects). For extraversion divided into quartiles, the three lowest quartiles generally exhibited large decreases in symptoms, whereas the high extraversion group showed medium (perceived stress) to small (depression) decreases. MBCT seems to be effective to decrease symptoms of anxiety, depression, and perceived stress for a broad range of person characteristics in patients with diabetes. However, men and those high in extraversion showed considerably lower effectiveness compared to the other groups. The small effect in high extraverts may be due to the large dropout in this subgroup.
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 17
- Efficacy and Moderation of Mobile App–Based Programs for Mindfulness-Based Training, Self-Compassion Training, and Cognitive Behavioral Psychoeducation on Mental Health: Randomized Controlled Noninferiority Trial JMIR Mental Health July 29, 2018
- Effectiveness, Acceptability, and Mechanisms of Change of the Internet-Based Intervention StudiCare Mindfulness for College Students: a Randomized Controlled Trial Mindfulness August 10, 2022
- The Effectiveness of Mindfulness- Based Cognitive Therapy on Cognitive Failure and Emotional Processing in Anxious Nurses Iran Journal of Nursing October 1, 2016
- Brief Mindfulness-Based Cognitive Therapy in Women With Myocardial Infarction: Results of a Multicenter Randomized Controlled Trial. JACC. Advances February 1, 2025
- Psychosocial factors associated with engagement and efficacy of mindfulness intervention in the classroom. PLoS One June 25, 2026
and 12 more in the library
Cites 12
- The benefits of being present: Mindfulness and its role in psychological well-being. Journal of Personality and Social Psychology 2003
- Using Self-Report Assessment Methods to Explore Facets of Mindfulness Assessment January 27, 2006
- Mindfulness: A proposed operational definition. Clinical Psychology Science and Practice 2004
- Construct Validity of the Five Facet Mindfulness Questionnaire in Meditating and Nonmeditating Samples Assessment February 29, 2008
- Effects of Mindfulness-Based Stress Reduction Intervention on Psychological Well-being and Quality of Life: Is Increased Mindfulness Indeed the Mechanism? Annals of Behavioral Medicine June 1, 2008
and 7 more in the library