Potential treatment mechanisms in a mindfulness‐based intervention for people with progressive multiple sclerosis
Open accessAbstract
Objectives: To explore putative mediators of a mindfulness‐based intervention to decrease distress in people with multiple sclerosis (MS) and to explore the patients’ perspectives on this intervention. Design: We used an explanatory mixed methods design incorporating quantitative data from a pilot randomized control trial and a qualitative interview study with people who completed the mindfulness intervention. Methods: People with MS ( n = 40) completed standardized measures of distress (outcome), and acceptance, decentring, self‐compassion, and self‐efficacy (potential mediators). Semi‐structured interviews ( n = 15) of patients’ experiences of the mindfulness intervention were analysed deductively and inductively. Results: Decentring post‐intervention explained 13% of the 3‐month change in distress and between 27% and 31% of concurrent changes in distress. Acceptance changed only slightly, and as a result, the indirect effect accounts for only 2% of future distress and between 3% and 11% of concurrent distress. Qualitative data showed that acceptance and self‐compassion needed more time to develop, whereas decentring could be implemented readily after being introduced in the sessions. Self‐efficacy also had a large mediating effect. Participants in their interviews talked about group dynamics and prior expectations as essential elements that determine their engagement with the course and their level of satisfaction. Conclusions: Mindfulness interventions for people with a chronic progressive condition may benefit from focusing on helping them to accept daily challenges and teach them to recognize their thoughts and feelings, allowing time for acceptance and self‐compassion to develop. Group dynamics also play a fundamental role in the success of the mindfulness interventions. Statement of Contribution: What is already known on this subject? Mindfulness courses improve psychological well‐being for people with chronic conditions. Mindfulness courses have been successful in improving psychological well‐being and symptom management for people with multiple sclerosis but we do not know how these courses work. What does this study add? Decentering and self‐efficacy appear to be key mechanisms leading to reduced distress. Acceptance and self‐compassion may need more time and practice to develop. Group dynamics and expectations of the mindfulness courses were also important elements of mindfulness.
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There are validation studies for HADS showing good psychometric properties.
“There are also some validation studies for HADS showing good psychometric properties [58–61].”
From Distant delivery of a mindfulness-based intervention for people with Parkinson's disease: The study protocol of a randomised pilot trial (2017) · cites this paper as [61]
The Primary outcome section discusses the GHQ-12, while Putative Mediators discusses the psychometric properties of other measures. Searches for “HADS” and “Hospital Anxiety and Depression Scale” found no passage in our copy addressing HADS validation or its psychometric properties; page numbers were unavailable. (LLM, conf=0.76)
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- Authors
- Bogosian, A., Hughes, A., Norton, S., Silber, E., & Moss‐Morris, R.
- Affiliations
- City, University of London (GB)
- King's College London (GB)
- King's College Hospital (GB)
- Psychology Department Institute of Psychiatry, Psychology & Neuroscience King's College London UK
- Corresponding author
- Bogosian, Angeliki
- Venue
- British Journal of Health Psychology
- Publisher
- Wiley
- Published
- 2016-10-06
- Volume
- 21
- Issue
- 4
- Pages
- 859-880
- ISSN
- 1359-107X (ISSN-L)
- 2044-8287
- OpenAlex
- W2405477516
- Cited by
- 75
- References
- 89
- Citations by year
- 2026: 4 · 2025: 6 · 2024: 4 · 2023: 1 · 2022: 5 · 2021: 10 · 2020: 3 · 2019: 27 · 2018: 9 · 2017: 5 · 2015: 1
- FWCI
- 18.27
- Type
- journal article
- Language
- en
- Open access
- green
- kclpure.kcl.ac.uk
- Licence
- Locations
- British Journal of Health Psychology (publishedVersion)
- PubMed (publishedVersion)
- City Research Online (City University London) (acceptedVersion)
- Research Portal (King's College London) (submittedVersion, other-oa)
- Funders
- MS Society UK (961/11)
- Topics
- Social Sciences › Psychology › Clinical Psychology › Mindfulness and Compassion Interventions
- Health Sciences › Medicine › Pathology and Forensic Medicine › Multiple Sclerosis Research Studies
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Keywords
- mindfulness-based interventions, multiple sclerosis, progressive multiple sclerosis, distress, mediators, acceptance, decentering, self-compassion, self-efficacy, group dynamics, patient perspectives, chronic disease, psychological well-being
- MeSH terms
- Adult, Empathy, Female, Humans, Male, Middle Aged, Pilot Projects, Stress, Psychological, Randomized Controlled Trials as Topic, Patient Satisfaction, Self Efficacy, Multiple Sclerosis, Chronic Progressive, Qualitative Research, Mindfulness
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