Testing a Moderated Mediation Model of MBCT’s Effects for Psoriasis Patients

Abstract

Objectives: The evidence base supporting the positive impact of mindfulness-based programs (MBPs) has increased over the last decade. Methodological limitations in this literature, however, limit the extent to which it can be said that compelling evidence of MBP efficacy exists. The mechanisms by which MBPs effect change are also unclear. This study attempts to identify these mechanisms. Methods: This study used data from an RCT (N = 101) investigating the impact of a mindfulness-based cognitive therapy (MBCT) program on self-reported psoriasis, depression, anxiety, and psychological wellbeing. We tested moderated mediation effects of changes in attention regulation, self-compassion, acceptance, mindfulness, non-attachment, aversion, rumination and worry scores post intervention on anxiety, depression, and psychological wellbeing. Total, direct and indirect effects were estimated by bootstrapped moderated mediation analyses providing 95% bias-corrected bootstrap confidence intervals. Results: The results indicated that changes in self-compassion were associated with changes in anxiety and attention regulation with psychological wellbeing when moderated by group allocation post intervention. Decreases in aversion were also found to be significantly associated with improved psychological wellbeing when mediated by reduced rumination, and reduced anxiety when mediated by decreases in worry. Increased mindfulness was found to be significantly associated with reduced anxiety when mediated by reduced worry. Conclusion: This study provides some initial evidence on what the mechanisms of mindfulness might be.