, Volume 10, Issue 12, pp 2673–2681 | Cite as

Testing a Moderated Mediation Model of MBCT’s Effects for Psoriasis Patients

  • Alan MaddockEmail author
  • David Hevey
  • Paul D’Alton
  • Brian Kirby



The evidence base supporting the positive impact of mindfulness-based programs (MBPs) has increased over the last decade. Methodological limitations in this literature, however, limit the extent to which it can be said that compelling evidence of MBP efficacy exists. The mechanisms by which MBPs effect change are also unclear. This study attempts to identify these mechanisms.


This study used data from an RCT (N = 101) investigating the impact of a mindfulness-based cognitive therapy (MBCT) program on self-reported psoriasis, depression, anxiety, and psychological wellbeing. We tested moderated mediation effects of changes in attention regulation, self-compassion, acceptance, mindfulness, non-attachment, aversion, rumination and worry scores post intervention on anxiety, depression, and psychological wellbeing. Total, direct and indirect effects were estimated by bootstrapped moderated mediation analyses providing 95% bias-corrected bootstrap confidence intervals.


The results indicated that changes in self-compassion were associated with changes in anxiety and attention regulation with psychological wellbeing when moderated by group allocation post intervention. Decreases in aversion were also found to be significantly associated with improved psychological wellbeing when mediated by reduced rumination, and reduced anxiety when mediated by decreases in worry. Increased mindfulness was found to be significantly associated with reduced anxiety when mediated by reduced worry.


This study provides some initial evidence on what the mechanisms of mindfulness might be.


Mindfulness Mechanisms Psoriasis Moderated mediation 


Author Contribution

AM: designed and executed the study, assisted in intervention delivery, collected the data, conducted the statistical analysis and wrote the paper. DH: collaborated with the study design, statistical analysis and paper preparation. PD: collaborated with the study design, intervention delivery and paper preparation. BK: collaborated in study design and paper preparation. All authors approved the final version of the manuscript for submission.

Funding Information

This research was funded by the Health Research Board SPHeRE/2013/1.

Compliance with Ethical Standards

Ethical Approval

Ethical approval for the study was provided by St. Vincent’s Healthcare Group Ethics and Medical Research Committee and the School of Psychology, Trinity College Dublin. All procedures performed were in accordance with the ethical standards of the institutional and/or national research committee and with the Declaration of Helsinki (World Medical Association 2013) or comparable ethical standards.

Informed Consent

Informed consent was obtained from all individual participants included in the study.

Conflict of Interest

The authors declare that they have no conflict of interest.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.School of PsychologyTrinity CollegeDublin 2Ireland
  2. 2.St.Vincent’s University HospitalDublin 4Ireland

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