Abstract
Objectives
Cognitive behavioral and mindfulness interventions have been shown to promote well-being in individuals with chronic illness. However, the underlying psychological processes through which these interventions impact well-being are not fully explored. This secondary analysis study aimed to examine the role of perceived social support, interpersonal sensitivity, and perceived stress as mediators of the positive effect of individualized online Cognitive Behavioral and Mindfulness Intervention (COBMINDEX) on life satisfaction among patients with Crohn’s disease (CD).
Method
Patients with mild or moderately active disease (n=142) were randomly assigned to either COBMINDEX intervention or treatment-as-usual control group. After a period of 3 months, the control group also received the COBMINDEX intervention. Complete data were collected from 120 patients (COBMINDEX=60, TAU=60). Analysis of covariance assessed group differences in post-intervention scores, controlling for baseline scores. Multiple parallel mediation analysis assessed the proposed mechanisms for the entire sample.
Results
Individuals in the COBMINDEX condition reported significantly lower levels of perceived stress (F=28.06, p<0.01) and interpersonal sensitivity (F=12.78, p<0.01) than those in the control condition. The COBMINDEX group also had significantly higher levels of life satisfaction (F=9.79, p<0.01) compared to the control group. Perceived social support did not differ across groups (F=2.73, p=0.10). Analysis of indirect effects revealed significant effects of perceived stress (b=0.52, 95% CI [0.16, 1.03]) and interpersonal sensitivity (b=0.73, 95% CI [0.31, 1.35]); thus, the positive effect of COBMINDEX on life satisfaction was mediated by changes in interpersonal sensitivity and perceived stress.
Conclusions
The findings highlight the importance of targeting mental processes such as interpersonal sensitivity to enhance patients’ life satisfaction. These findings suggest that practitioners might consider COBMINDEX as an adjunct intervention for patients with CD.
Preregistration
The study was registered with ClinicalTrials.gov (Identifier: NCT05085925) and with the Ministry of Health in Israel (https://my.health.gov.il/CliniTrials/Pages/MOH_2020-02-24_008721.aspx ).
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Data Availability
The datasets used and/or analyzed during the current study are available from the corresponding author upon reasonable request.
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Acknowledgements
The authors are grateful to members of the Israel IBD Research Nucleus (IIRN) who contributed to data collection, including Iris Dotan, Yehuda Chowers, Rami Eliakim, Dan Turner, Heba Abu Kaf, Henit Yanai, Hagar Banai, and Shomron Ben-Horin. The authors are also grateful to three anonymous referees and the Editors of this journal for their valuable comments and suggestions.
Funding
This work was supported by the Leona M. and Harry B. Helmsley Charitable Trust (Grant numbers: 2018PG-CD005 and 2203-05901).
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SR: methodology, formal analyses, writing—original draft preparation, subsequent drafts, review, and editing. GG: investigation, project administration, writing—review and editing. VSN: conceptualization, methodology, writing—review and editing. DS: conceptualization; writing—review and editing; funding acquisition. MF: conceptualization, writing—review and editing. RS: software, data curation. DG: conceptualization, writing—review and editing. AM: conceptualization, writing—review and editing. AN: writing—review and editing. SO: conceptualization; writing—review and editing; funding acquisition; supervision. OS: conceptualization, methodology, supervision, writing—review and editing.
All authors reviewed and approved the final version of the manuscript.
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Ethics
The institutional review boards of the participating hospitals Soroka Medical Center and Rabin Medical Center, Israel, approved the study in accordance with the Helsinki Declaration of 1975, as revised in 2008. The study was conducted in line with all requirements.
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Written informed consent was obtained from all individual participants included in the study.
Conflict of Interest
DS has served as a speaker, a consultant, and/or an advisory board member for Takeda Pharmaceutical Co. Ltd., AbbVie Inc., Pfizer Inc., Janssen Pharmaceuticals Inc., Ferring Pharmaceuticals Inc., and Neopharm Labs Inc. GG has served as a speaker for Ferring Pharmaceuticals. All other authors have no conflicts to report.
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Regev, S., Goren, G., Slonim-Nevo, V. et al. Effectiveness of Cognitive-Behavioral and Mindfulness Intervention in Improving Life Satisfaction of Patients with Crohn’s Disease: Evaluating Stress, Interpersonal Sensitivity, and Social Support as Mechanisms of Change. Mindfulness 14, 2626–2640 (2023). https://doi.org/10.1007/s12671-023-02220-6
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DOI: https://doi.org/10.1007/s12671-023-02220-6