Pruessner Luise, Timm Christina, Kalmar Julia, Bents Hinrich, Barnow Sven, Mander Johannes
Department of Psychology, Heidelberg University, Heidelberg, Germany.
Center for Psychological Psychotherapy, Heidelberg University, Heidelberg, Germany.
Depress Anxiety. 2024 Apr 2;2024:9081139. doi: 10.1155/2024/9081139. eCollection 2024.
The global prevalence of depression and anxiety disorders underscores the need for a more profound comprehension of effective treatments. Mindfulness has shown promise in enhancing treatment outcomes and preventing relapse in these conditions, but the underlying mechanisms remain poorly understood.
This study examined the role of emotion regulation as a mediator in the relationship between changes in mindfulness and the reduction of depression and anxiety symptoms during individual cognitive-behavioral therapy (CBT). We tracked longitudinal changes in mindfulness, emotion regulation, depression, and anxiety at baseline (pre), early treatment (session 5), midtreatment (session 15), and posttreatment (session 25) in 162 patients with depression and anxiety disorders. Further, we examined whether the effects of mindfulness on emotion regulation could be enhanced by introducing a brief mindfulness intervention at the beginning of each CBT session, as compared to progressive muscle relaxation and individual psychotherapy without any standardized session-introducing interventions.
Multilevel structural equation modeling indicated that decreases in rumination and increases in reappraisal and acceptance mediated the relationship between mindfulness and reductions in depressive symptoms. In contrast, reductions in avoidance explained the association between mindfulness and changes in anxiety symptoms. These links remained unchanged when adding a mindfulness intervention into individual CBT.
Results support emotion regulatory properties of mindfulness and highlight distinct pathways of symptom reduction in depression and anxiety. These findings have important implications for understanding the mechanisms of mindfulness and tailoring treatment to individual patient needs. This trial is registered with NTC02270073.
抑郁症和焦虑症在全球的患病率凸显了更深入理解有效治疗方法的必要性。正念已显示出在改善这些疾病的治疗效果和预防复发方面的前景，但其潜在机制仍知之甚少。
本研究考察了情绪调节在个体认知行为疗法（CBT）中作为正念变化与抑郁和焦虑症状减轻之间关系的中介作用。我们追踪了162名抑郁症和焦虑症患者在基线（治疗前）、治疗早期（第5次治疗）、治疗中期（第15次治疗）和治疗后（第25次治疗）时正念、情绪调节、抑郁和焦虑的纵向变化。此外，我们还考察了与渐进性肌肉松弛和无任何标准化开场干预的个体心理治疗相比，在每次CBT治疗开始时引入简短的正念干预是否能增强正念对情绪调节的影响。
多层次结构方程模型表明，沉思的减少以及重新评估和接纳的增加介导了正念与抑郁症状减轻之间的关系。相比之下，回避行为的减少解释了正念与焦虑症状变化之间的关联。在个体CBT中加入正念干预后，这些联系保持不变。
结果支持正念的情绪调节特性，并突出了抑郁症和焦虑症症状减轻的不同途径。这些发现对于理解正念机制以及根据个体患者需求定制治疗具有重要意义。本试验已在NTC02270073注册。
