Background

The present study investigates possible predictors of treatment response in an Internet-delivered Mindfulness-Based Cognitive Therapy (iMBCT) intervention with therapist support. This iMBCT program, a fully online delivered intervention with asynchronous therapist support, has previously been shown to be efficacious in reducing symptoms of anxiety and depression in women treated for breast cancer and men treated for prostate cancer.

Methods

Eighty-two breast- and prostate cancer survivors experiencing psychological distress received 8 weeks of therapist-guided iMBCT. Primary outcomes were improvement in anxiety and depression scores from baseline to post-treatment and from baseline to six-months follow-up. Clinical predictors included levels of depression and anxiety at the time of screening and at baseline, as well as time since diagnosis. Demographic predictors included age and educational level. Therapy-related predictors included working alliance, self-compassion, and five facets of mindfulness. Mixed Linear Models were employed to test the prediction effects over time.

Results

Higher levels of baseline depression were associated with increased treatment response in anxiety at post-treatment, and lower levels of self-compassion were associated with increased treatment response in depression at post-treatment. None of the proposed predictors significantly predicted treatment response at six-months follow-up.

Conclusion

The findings suggest that iMBCT can be provided for cancer survivors regardless of their age, educational level, and time since diagnosis (up to five years) and that therapeutic alliance is not crucial for treatment response. We did not identify characteristics predicting treatment response, although many factors were tested. Still, other characteristics may be predictors, and given the relatively small sample size and a large number of statistical tests, the results should be interpreted with caution.

中文翻译：

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互联网提供的基于正念的癌症幸存者焦虑和抑郁认知疗法：治疗反应的预测因子

背景

本研究调查了在治疗师支持下进行的基于互联网的正念认知疗法 (iMBCT) 干预中治疗反应的可能预测因素。该 iMBCT 计划是一种完全在线提供的干预措施，具有异步治疗师的支持，此前已被证明可有效减轻接受乳腺癌治疗的女性和接受前列腺癌治疗的男性的焦虑和抑郁症状。

方法

82 名经历心理困扰的乳腺癌和前列腺癌幸存者接受了 8 周的治疗师指导的 iMBCT。主要结果是焦虑和抑郁评分从基线到治疗后以及从基线到六个月随访的改善。临床预测因素包括筛查时和基线时的抑郁和焦虑水平，以及诊断后的时间。人口预测因素包括年龄和教育水平。与治疗相关的预测因素包括工作联盟、自我同情和正念的五个方面。混合线性模型被用来测试预测效果随时间的变化。

结果

较高水平的基线抑郁与治疗后焦虑症的治疗反应增加有关，而较低水平的自我同情与治疗后抑郁症的治疗反应增加有关。所提出的预测因子均未显着预测六个月随访时的治疗反应。

结论

研究结果表明，无论癌症幸存者的年龄、教育水平和诊断后的时间（长达五年）如何，都可以为他们提供 iMBCT，并且治疗联盟对于治疗反应并不重要。尽管测试了许多因素，但我们没有确定预测治疗反应的特征。尽管如此，其他特征可能是预测因素，并且鉴于样本量相对较小和大量统计测试，应谨慎解释结果。