Shomaker Lauren B, Bruggink Stephanie, Pivarunas Bernadette, Skoranski Amanda, Foss Jillian, Chaffin Ella, Dalager Stephanie, Annameier Shelly, Quaglia Jordan, Brown Kirk Warren, Broderick Patricia, Bell Christopher
Department of Human Development and Family Studies, Colorado State University, United States; Department of Community and Behavioral Health, Colorado School of Public Health, United States.
Department of Human Development and Family Studies, Colorado State University, United States.
Complement Ther Med. 2017 Jun;32:66-74. doi: 10.1016/j.ctim.2017.04.003. Epub 2017 Apr 15.
(1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance.
Parallel-group, randomized controlled pilot trial conducted at a university.
Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16).
Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation.
Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition.
Most adolescents attended ≥80% sessions (mindfulness: 92% versus cognitive-behavioral: 87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05).
A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance. ClinicalTrials.gov identifier: NCT02218138 clinicaltrials.gov.
（1）评估基于正念的团体干预对有2型糖尿病（T2D）风险且有抑郁症状的青春期女孩的可行性和可接受性，以及（2）比较基于正念的团体干预与认知行为团体干预在减轻抑郁症状和改善胰岛素抵抗方面的效果。
在一所大学进行的平行组随机对照试验。
33名年龄在12 - 17岁、超重/肥胖、有糖尿病家族史且抑郁症状加重的女孩被随机分为为期六周的基于正念的干预组（n = 17）或认知行为干预组（n = 16）。
两种干预均包括每周一次、每次一小时、共六次的团体课程。基于正念的课程包括引导式正念觉知练习。认知行为课程包括认知重构和行为激活。
在基线、干预后和六个月时对青少年进行评估。通过出勤率和课程评分来衡量可行性/可接受性。通过经过验证的调查评估抑郁症状。根据空腹胰岛素和血糖测定胰岛素抵抗，并使用双能X线吸收法评估身体成分。
大多数青少年参加了≥80%的课程（正念组：92%，认知行为组：87%，p = 1.00）。可接受性评分较高。在治疗后和六个月时，正念组青少年的抑郁症状减轻程度大于认知行为组青少年（p <.05）。与认知行为组相比，在调整脂肪量和其他协变量后，基于正念干预的青少年在治疗后胰岛素抵抗和空腹胰岛素的降低幅度也更大（p <.05）。
基于正念的干预对有T2D风险且有抑郁症状的女孩显示出可行性和可接受性。与认知行为课程相比，干预后，接受正念干预的青少年抑郁症状减轻更多，胰岛素抵抗改善更好。ClinicalTrials.gov标识符：NCT02218138 clinicaltrials.gov。
