Mediators of a Mindfulness-Based Intervention for Younger Breast Cancer Survivors: Effects on Depressive Symptoms.

Autor:	Korecki JRT; From the Department of Psychology (Korecki, Bower), UCLA, Los Angeles; UCLA Jonsson Comprehensive Cancer Center (Ganz, Petersen, Crespi, Bower); Department of Health Policy and Management (Ganz), UCLA Fielding School of Public Health; Department of Medicine, Division of Hematology-Oncology (Ganz), David Geffen School of Medicine at UCLA, Los Angeles, California; Department of Medical Oncology (Partridge), Dana-Farber Cancer Institute; Department of Medicine (Partridge), Brigham and Women's Hospital; Harvard Medical School (Partridge), Boston, Massachusetts; The Johns Hopkins University School of Medicine and Sidney Kimmel Comprehensive Cancer Center (Wolff), Baltimore, Maryland; Department of Biostatistics (Crespi), UCLA Fielding School of Public Health; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine (Bower), UCLA, Los Angeles; and Cousins Center for Psychoneuroimmunology, Semel Institute for Neuroscience and Human Behavior (Bower), Los Angeles, California., Ganz PA, Partridge AH, Wolff AC, Petersen L, Crespi CM, Bower JE
Jazyk:	angličtina
Zdroj:	Psychosomatic medicine [Psychosom Med] 2024 Oct 01; Vol. 86 (8), pp. 700-709. Date of Electronic Publication: 2024 Aug 10.
DOI:	10.1097/PSY.0000000000001340
Abstrakt:	Objective: Depression is associated with poor outcomes in breast cancer patients, with higher prevalence among younger women. Although mindfulness-based interventions (MBIs) have demonstrated therapeutic effects, the mechanisms of intervention effects are poorly understood. We investigated whether rumination, self-kindness, intrusive thoughts about cancer, cancer-related worry, or a sense of meaning and peace mediated the intervention effects of an MBI, Mindful Awareness Practices (MAPs), on depressive symptoms. Additionally, we explored the same variables as mediators of a psychoeducation program, Survivorship Education (SE). Methods: Women diagnosed with stage 0-III breast cancer at age <50 years were randomized to 6 weeks of MAPs ( n = 85), SE ( n = 81), or wait-list control (WLC; n = 81). During preintervention, postintervention, and 6-month follow-up (FU), we assessed depressive symptoms, rumination, self-kindness, intrusive thoughts, worry, and meaning and peace. Results: MAPs and SE significantly reduced depressive symptoms at postintervention, and reductions remained through 6-month FU for MAPs. Models revealed that reductions in rumination ( β = -0.68, 95% confidence interval [CI] = -1.64 to -0.07) and intrusive thoughts ( β = 1.17, 95% CI = -2.17 to -0.37) and improvements in self-kindness ( β = -1.09, 95% CI = -2.37 to -0.28) and meaning and peace ( β = -1.09, 95% CI = -3.16 to -0.56) mediated MAPs' effects at all time points. Reductions in worry ( β = -1.34, 95% CI = -2.47 to -0.45]) mediated effects at postintervention only. Worry and intrusive thoughts mediated SE effects at postintervention and 6-month FU, respectively. Conclusions: Findings identified depression-relevant mediators of MAPs' effects, expanding the understanding of MBI mechanisms. Results highlight pathways that could be leveraged to optimize intervention outcomes. Trial Registration: ClinicalTrials.gov identifier: NCT03025139 . (Copyright © 2024 by the American Psychosomatic Society.)
Databáze:	MEDLINE
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