Mediators of change in online mindfulness-based cognitive therapy: A secondary analysis of a randomized trial of mindful mood balance.

OBJECTIVE

Digital delivery of mindfulness-based cognitive therapy through the Mindful Mood Balance (MMB) program is clinically effective (Segal et al., 2020); however, the mechanisms through which this program delivers its benefits have not been established.

METHOD: This study investigates the differential impact of the MMB program paired with usual depression care (UDC) compared to UDC alone on the putative targets of self-reported mindfulness, decentering, and rumination and the extent to which change in these targets mediates subsequent depressive relapse among a sample of predominantly White, female participants, with residual depressive symptoms.

RESULTS

The MMB program relative to UDC was associated with a significantly greater rate of change in decentering (t = 4.94, p < .0001, d = 0.46), mindfulness (t = 6.04, p < .0001, d = 0.56), and rumination (t = 3.82, p < .0001, d = 0.36). Subsequent depressive relapse also was mediated by prior change in these putative targets, with a significant natural indirect effect for decentering, χ2(1) = 7.25, p < .008, OR = 0.57; mindfulness, χ2(1) = 9.99, p < .002, OR = 0.50; and rumination, χ2(1) = 12.95, p < .001, OR = 0.35.

CONCLUSIONS

These findings suggest the mechanisms of MMB are consistent with the conceptual model for mindfulness-based cognitive therapy and depressive relapse risk and that such processes can be modified through digital delivery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).