The Mechanisms of Mindfulness-Based Stress Reduction and Mindfulness-Based Cognitive Therapy for Cancer Patients and
Lauren M Carney1, Crystal L Park2, Pooja Hingorany2
1Department of Population Health Science and Policy, Center for Behavioral Oncology, Icahn School of Medicine at Mount Sinai.
Abstract:
While many systematic reviews have focused on relationships between mindfulness-based interventions (MBIs) and myriad outcomes, no systematic review has examined the mechanisms through which MBIs affect outcomes in the context of cancer. A systematic review was conducted of experimental or quasi-experimental studies that longitudinally examined potential mechanisms of the effects of either mindfulness-based stress reduction (MBSR) or mindfulness-based cognitive therapy (MBCT) interventions with adult cancer patients and survivors. Searches were conducted in Pubmed, APA PsycInfo, Cumulated Index to Nursing and Allied Health Literature, Cochrane, and Scopus databases up to May 2022. The results of included studies were narratively synthesized and studies were graded for quality using a rubric tailored to mediational intervention studies. Of 156 experimental or quasi-experimental studies that implemented either MBSR or MBCT interventions with adult cancer patients and survivors, only 13 longitudinally tested for mediators (e.g., changes in mindfulness, rumination, and self-compassion) of intervention effects. Most studies lacked a strong, active control group and most (10/13) were of medium quality. Results on mindfulness as a mediator of intervention effects were inconclusive, and many other mediators were only tested within a single study. Methodological limitations, including lack of strong comparison groups and theoretical frameworks and inconsistent conceptualizations of mindfulness, preclude drawing strong conclusions from the current body of evidence. MBIs may operate differently for cancer patients/survivors, highlighting the importance of continuing to test for mediation within this population.
Insights
This systematic review found limited evidence on how mindfulness interventions work for cancer patients. More research is needed to understand the mechanisms of mindfulness-based stress reduction and mindfulness-based cognitive therapy in this population.
Area of Science:
- Oncology
- Psychology
- Behavioral Medicine
Background:
- Mindfulness-based interventions (MBIs) are widely studied for various outcomes.
- However, the specific mechanisms through which MBIs influence outcomes in cancer patients remain unclear.
- This review focuses on understanding these mediating factors.
Purpose of the Study:
- To systematically review studies examining the mechanisms of mindfulness-based stress reduction (MBSR) and mindfulness-based cognitive therapy (MBCT) in adult cancer patients and survivors.
- To identify potential mediators of MBI effects in this population.
- To assess the quality of existing research on MBI mechanisms in cancer care.
Main Methods:
- Systematic review of experimental or quasi-experimental studies.
- Searches conducted in major databases (PubMed, PsycInfo, CINAHL, Cochrane, Scopus) up to May 2022.
- Narrative synthesis of results and quality grading using a tailored rubric for mediational studies.
Main Results:
- Only 13 of 156 studies longitudinally tested mediators of MBIs in cancer patients.
- Mindfulness as a mediator was inconclusive; other mediators were tested in single studies.
- Most studies lacked strong control groups and were of medium quality.
Conclusions:
- Current evidence on MBI mechanisms in cancer is limited due to methodological weaknesses.
- Inconclusive findings on mediators like mindfulness, rumination, and self-compassion.
- MBIs may have unique effects in cancer populations, necessitating further mediation research.
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