Distress tolerance as a mediator of mindfulness-based intervention for anxiety and depression: Evidence from two randomized controlled trials.
Yanjuan Li, Mengyao He, Zhenzhen Wang, Stefan G Hofmann, Xinghua Liu
International journal of clinical and health psychology : IJCHP January 1, 2024 DOI: 10.1016/j.ijchp.2024.100445 via PubMed
Summary
AI-generated from the abstractAcross two randomized controlled trials, a mindfulness-based intervention (MBI) improved mindfulness, distress tolerance, anxiety, and depression more than control conditions. In Study 1, 374 adults with moderate emotional distress were assigned to MBI or a waitlist; in Study 2, 170 adults with emotional disorders were assigned to MBI or a control group. Changes in distress tolerance explained the intervention's effects on anxiety and depression. Distress tolerance also preceded improvements in depression over time, but not in anxiety. Distress tolerance appears to be a mechanism through which MBIs reduce emotional distress, suggesting that boosting distress tolerance could strengthen these interventions.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 544 |
| Population | Adults with at least moderate emotional distress (Study 1) or emotional disorders (Study 2) |
| Intervention | Mindfulness-based intervention |
| Duration | 8-week intervention (implied by weekly assessments and post-test) |
| Topics | Anxiety Depression |
| Keywords | Distress tolerance Mechanism Mindfulness-based intervention |
| Citations | 18 |
| Key finding | Distress tolerance mediated the effects of mindfulness-based intervention on changes in anxiety and depression in two randomized controlled trials. |
Abstract
We aimed to investigate whether distress tolerance mediated the effects of mindfulness-based intervention (MBI) on anxiety and depression with two randomized controlled studies. In Study 1, 374 participants with at least moderate emotional distress were randomized to an intervention group (N = 174) and a waitlist control group (N = 173). Mindfulness, distress tolerance, anxiety, and depression were measured at the pre-test, week 3, week 5, and post-test. In Study 2, 170 participants with emotional disorders were randomized to an intervention group (N = 86) and a control group (N = 84). The same variables were assessed at pre-test, weekly during the intervention, and post-test. In both studies, linear mixed effect models showed that compared to the control group, mindfulness, distress tolerance, anxiety, and depression significantly improved in the intervention group. Parallel process latent growth curve models showed that changes in distress tolerance mediated the effects of the MBI on changes in anxiety and depression. Random-intercept cross-lagged panel models found that distress tolerance temporally preceded depression, but not anxiety. Distress tolerance is a potential mechanism underlying MBIs. Interventions targeting distress tolerance could be embedded in MBIs to enhance the intervention effects for emotional distress.