Joss Diane, Teicher Martin H, Lazar Sara W
Developmental Biopsychiatry Research Program, McLean Hospital, Belmont, MA, USA.
Department of Psychiatry, Massachusetts General Hospital, USA.
Mindfulness (N Y). 2024 Sep;15(9):2245-2261. doi: 10.1007/s12671-024-02439-x. Epub 2024 Sep 5.
Mindfulness-based interventions (MBIs) have been shown to be beneficial for young adults with adverse childhood experiences (ACE), but the temporal course of the therapeutic effects is still not well understood. This study aimed to investigate MBI-induced weekly changes and long-term effects in trait mindfulness and psychological symptoms.
This study analyzed longitudinal data from a mechanistic clinical trial in which young adults (aged 21-35) with ACE were randomized to an 8-week MBI or an active control condition of Stress Management Education (SME), with 21 and 19 completers respectively. Mindful Attention Awareness Scale (MAAS), Perceived Stress Scale (PSS), and Kellner's Symptom Questionnaire (KSQ) were administered before, after, and weekly during the 8-week interventions, and at 6-, 12-, and 18-months follow-up. Data analyses were conducted with linear mixed effects models, Granger causality and Dynamic Structural Equation Modeling (DSEM).
Group by time interaction effects were observed with PSS, MAAS, KSQ-depression, KSQ-hostility, and KSQ-anxiety with small effect sizes. Only in the MBI group, increases of MAAS scores predicted reductions of PSS, KSQ-somatization, and KSQ-hostility scores. MAAS score reached significant increase at the end of MBI, and most MBI-induced symptom reduction lasted 12 months without refresher courses.
MBI demonstrated unique effects of trait mindfulness improvement leading to psychological symptom reductions. At least 8 weeks of MBI program duration and refreshment at 12 months may be necessary for ACE survivors.
This study is not preregistered.
基于正念的干预措施(MBIs)已被证明对有童年不良经历(ACE)的年轻人有益,但治疗效果的时间进程仍未得到很好的理解。本研究旨在调查MBI诱导的特质正念和心理症状的每周变化及长期影响。
本研究分析了一项机制性临床试验的纵向数据,该试验将有ACE的年轻人(21 - 35岁)随机分为为期8周的MBI组或压力管理教育(SME)的积极对照组,分别有21名和19名完成者。在8周干预期间的前、后及每周,以及在6个月、12个月和18个月随访时,分别施测正念注意觉知量表(MAAS)、感知压力量表(PSS)和凯尔纳症状问卷(KSQ)。采用线性混合效应模型、格兰杰因果关系和动态结构方程模型(DSEM)进行数据分析。
观察到PSS、MAAS、KSQ - 抑郁、KSQ - 敌意和KSQ - 焦虑的组间时间交互效应,效应量较小。仅在MBI组中,MAAS分数的增加预测了PSS、KSQ - 躯体化和KSQ - 敌意分数的降低。MAAS分数在MBI结束时显著增加,且大多数MBI诱导的症状减轻持续12个月,无需进修课程。
MBI显示出特质正念改善导致心理症状减轻的独特效果。对于有ACE经历的幸存者,MBI项目至少持续8周且在12个月时进行复习可能是必要的。
本研究未预先注册。