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Mediation and moderation analysis of a preventive Mindfulness-based Cognitive Therapy intervention

Vennemann, Christopher (2013) Mediation and moderation analysis of a preventive Mindfulness-based Cognitive Therapy intervention.

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Abstract:Introduction: Depression is among the most urgent health issues today, causing personal suffering and economical damage. Treatment alone does not appear sufficient to handle the increasing cases of depression. Primary prevention is necessary, and while prevention programs exist, many fall short. Mindfulness-based cognitive therapy is a rather new approach to mental health that is focused on positive mental health (well-being). This paper aims to evaluate Mindfulness-based cognitive therapy as a preventive intervention in terms of mediating and moderating effects. It was predicted that mindfulness and psychological flexibility would mediate mental health changes. Participant gender, educational level, baseline depressive and anxious symptoms were expected to moderate mental health changes. Method: The study featured 151 participants (mean age=47.9, SD=11.3). Participants were predominantly female (78.1%) and of Dutch nationality (94%). Participants were selected based on elevated, yet non-clinical depressive symptoms. They were randomly assigned to either a 12-week MBCT-based course (experimental condition) or a waiting-list group (control condition). The primary outcome was depressive symptomology (CES-D). Secondary outcomes were anxious symptomology (HADS-A) and positive mental health (MHC-SF). Process measures were mindfulness (FFMQ) and psychological flexibility/experiential avoidance (AAQ-II). Results: The total FFMQ and three of its facets as well as the AAQ-II mediated the effect the intervention had on post-treatment depression reduction. Similarly post-treatment anxiety reduction was mediated by the FFMQ, three of its facets, and the AAQ-II. Increase in positive mental health was mediated by the FFMQ, all of its subscales and the AAQ-II. No moderating effects were found for participant gender or educational level. Higher base-line depression as well as anxiety led to more pronounced reduction of anxiety in the MBCT group. Reduction of depressive symptoms was not moderated by those base-line measures. Increase in positive mental health was not moderated by base-line depression. Higher base-line anxiety did lead to an increase in positive mental health in the MBCT group, while leading to lower positive mental health scores in the control group. Discussion: This study supports the role of mindfulness and psychological flexibility in MBCT-based prevention programs for the mildly depressed. The intervention was equally beneficial for men and women, as well as highly vs. moderately educated participants. Lowly educated participants were underrepresented. Higher base-line symptoms did produce more beneficial outcomes for the MBCT group, but only for the secondary outcome measures anxiety and positive mental health.
Item Type:Essay (Bachelor)
Faculty:BMS: Behavioural, Management and Social Sciences
Subject:77 psychology
Programme:Psychology BSc (56604)
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