Self-Compassion and Resilience as Mediators of a 30-Day Internet-Delivered Mindfulness-Based Cognitive Therapy: A Pragmatic Open Trial
摘要
Brief, minimally guided, internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) formats may offer a scalable alternative, but evidence for their effectiveness and mechanisms remains limited. This pragmatic two-arm open trial evaluated the feasibility and preliminary effects of a 30-day asynchronous iMBCT program in a community sample. The primary outcomes were reductions in perceived stress and emotional distress; secondary analyses examined whether self-compassion and resilience functioned as processes of change.
MethodA total of 1348 adults reporting emotional distress were allocated to either the iMBCT program or a waiting list control (WLC). Due to high attrition, propensity score matching (PSM) was applied, yielding a final analytic sample of 190 individuals (91 iMBCT, 99 WLC). The intervention comprised six online MBCT sessions with audio-guided practices and psychoeducational materials. Outcomes (perceived stress, emotional distress, anxiety, depression, self-compassion, and resilience) were assessed at baseline and post-intervention using mixed-model ANOVA.
ResultsCompared with WLC, the iMBCT group showed significant reductions in perceived stress (ηp2 = 0.32, 95% CI [0.21, 0.41]), emotional distress (ηp2 = 0.38, [0.28, 0.47]), anxiety (ηp2 = 0.33, [0.22, 0.42]), and depression (ηp2 = 0.34, [0.24, 0.44]), alongside increases in self-compassion (ηp2 = 0.38, [0.27, 0.47]) and resilience (ηp2 = 0.28, [0.17, 0.37]). Mediation analyses indicated that improvements in self-compassion and resilience partially accounted for reductions in stress and distress, explaining 18–32% of the total effect across outcomes. The intervention experienced 67% attrition, and engagement metrics were not collected.
ConclusionsA brief, asynchronous iMBCT program can reduce self-reported stress, emotional distress, anxiety, and depression while enhancing self-compassion and resilience in a community sample. However, high attrition, reliance on self-report, and the absence of clinical diagnoses or follow-up assessments limit generalizability and conclusions about long-term effects. Future studies should test such interventions in clinical populations, incorporate guided or synchronous elements to improve adherence, and collect objective engagement data to clarify dose–response relationships.
PreregistrationThe study was not preregistered.