How does mindfulness-based stress reduction (mbsr) improve psychological functioning in cancer patients?
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2012
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Abstract
OBJECTIVE: This longitudinal waitlist controlled study examined mediators of MBSR in cancer patients. First, the study explored the timing of MBSR-related change and whether earlier changes in putative mediators were associated with later changes in outcome variables. Next, a mediation model was tested based on the theory that increased mindfulness through MBSR leads to enhanced emotion regulation (indexed by rumination, worry, and experiential avoidance), which in tum leads to improved psychological functioning. The study also assessed whether increased mindfulness mediated the effects of MBSR on spirituality and posttraumatic growth. METHODS: Patients were recruited from the MBSR program waitlist and were either registered for immediate participation (n=135), or were waiting for the next program (n=76). Participants completed questionnaires pre-, mid- and post-MBSR or waiting period (i.e., 0, 4 and 8 weeks). Hierarchical linear modeling (HLM) and piecewise HLM were employed to assess changes over time as a function of condition (MBSR vs. waitlist). Cross-lagged correlations and linear regression analyses explored temporal associations among changes in mediator and outcome variables. Mediation models were tested using linear regression and bootstrapping analyses. RESULTS: Compared to the waitlist group, MBSR participants showed significant changes in expected directions on all putatjve mediator and outcome variables. In the MBSR condition, present-focused nonjudgmental attention/awareness, worry, rumination and spirituality changed during the first and second halves of the program relative to the control group; all other variables changed only during the second half in the program. Early increases in the "non judging" mindfulness facet were associated with later decreases in worry, and early increases in the "describing" facet were associated with later increases in posttraumatic growth. However, more temporal associations emerged in the direction opposite of the proposed model. Mindfulness mediated the effect of MBSR on emotion regulation, which in tum mediated the effect of mindfulness on psychological functioning. Mindfulness also mediated the effect ofMBSR on "positive" outcomes. CONCLUSIONS: Increased mindfulness and enhanced emotion regulation are related to beneficial outcomes of MBSR in cancer patients. Findings suggest bi-directional effects of mediator and outcome variables, and illustrate the need for a more detailed analysis of MB SR-related change. Determining the precise timing of change in mindfulness and its sequelae will permit stronger conclusions regarding mechanisms ofMBSR.
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Bibliography: p. 146-181
Includes copy of ethics approval. Original copy with original Partial Copyright Licence.
Includes copy of ethics approval. Original copy with original Partial Copyright Licence.
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Citation
Labelle, L. E. (2012). How does mindfulness-based stress reduction (mbsr) improve psychological functioning in cancer patients? (Doctoral thesis, University of Calgary, Calgary, Canada). Retrieved from https://prism.ucalgary.ca. doi:10.11575/PRISM/4708