Resilient Stress Reactivity Profiles Predict Mental Health Gains from Online Contemplative Training: A Randomized Clinical Trial

Overview

Journal J Pers Med

Date 2024 May 25

PMID 38793075

Authors

Malvika Godara

Tania Singer

Affiliations

Soon will be listed here.

Abstract

Low-dose app-based contemplative interventions for mental health are increasingly popular, but heterogeneity in intervention responses indicates that a personalized approach is needed. We examined whether different longitudinal resilience-vulnerability trajectories, derived over the course of the COVID-19 pandemic, predicted differences in diverse mental health outcomes after mindfulness and socio-emotional dyadic online interventions. The CovSocial project comprised a longitudinal assessment (phase 1) and an open-label efficacy trial (phase 2). A community sample of 253 participants received 12 min daily app-based socio-emotional dyadic or mindfulness-based interventions, with weekly online coaching for 10 weeks. Before and after the intervention, participants completed validated self-report questionnaires assessing mental health. Stress reactivity profiles were derived from seven repeated assessments during the COVID-19 pandemic (January 2020 to March/April 2021) and were categorized into resilient (more plasticity) or vulnerable (less plasticity) stress recovery profiles. After both interventions, only individuals with resilient stress reactivity profiles showed significant improvements in depression symptomatology, trait anxiety, emotion regulation, and stress recovery. Those with vulnerable profiles did not show significant improvements in any outcome. Limitations of this study include the relatively small sample size and potential biases associated with participant dropout. Brief app-based mental interventions may be more beneficial for those with greater levels of stress resiliency and plasticity in response to stressors. More vulnerable individuals might require more intense and personalized intervention formats.

Citing Articles

10-Week Trajectories of Candidate Psychological Processes Differentially Predict Mental Health Gains from Online Dyadic versus Mindfulness Interventions: A Randomized Clinical Trial.

Godara M, Singer T J Clin Med. 2024; 13(11).

PMID: 38893006 PMC: 11172466. DOI: 10.3390/jcm13113295.

References

Kok B, Singer T . Effects of Contemplative Dyads on Engagement and Perceived Social Connectedness Over 9 Months of Mental Training: A Randomized Clinical Trial. JAMA Psychiatry. 2016; 74(2):126-134. DOI: 10.1001/jamapsychiatry.2016.3360. View

Goldberg S, Tucker R, Greene P, Davidson R, Wampold B, Kearney D . Mindfulness-based interventions for psychiatric disorders: A systematic review and meta-analysis. Clin Psychol Rev. 2017; 59:52-60. PMC: 5741505. DOI: 10.1016/j.cpr.2017.10.011. View

Smith B, Dalen J, Wiggins K, Tooley E, Christopher P, Bernard J . The brief resilience scale: assessing the ability to bounce back. Int J Behav Med. 2008; 15(3):194-200. DOI: 10.1080/10705500802222972. View

Webb C, Hirshberg M, Gonzalez O, Davidson R, Goldberg S . Revealing subgroup-specific mechanisms of change via moderated mediation: A meditation intervention example. J Consult Clin Psychol. 2023; 92(1):44-53. PMC: 10841335. DOI: 10.1037/ccp0000842. View

Hothorn T, Bretz F, Westfall P . Simultaneous inference in general parametric models. Biom J. 2008; 50(3):346-63. DOI: 10.1002/bimj.200810425. View

Kalisch R, Muller M, Tuscher O . A conceptual framework for the neurobiological study of resilience. Behav Brain Sci. 2014; 38:e92. DOI: 10.1017/S0140525X1400082X. View

Godara M, Rademacher J, Hecht M, Silveira S, Voelkle M, Singer T . Heterogeneous Mental Health Responses to the COVID-19 Pandemic in Germany: An Examination of Long-Term Trajectories, Risk Factors, and Vulnerable Groups. Healthcare (Basel). 2023; 11(9). PMC: 10177770. DOI: 10.3390/healthcare11091305. View

Goldberg S, Riordan K, Sun S, Davidson R . The Empirical Status of Mindfulness-Based Interventions: A Systematic Review of 44 Meta-Analyses of Randomized Controlled Trials. Perspect Psychol Sci. 2021; 17(1):108-130. PMC: 8364929. DOI: 10.1177/1745691620968771. View

Connor K, Davidson J . Development of a new resilience scale: the Connor-Davidson Resilience Scale (CD-RISC). Depress Anxiety. 2003; 18(2):76-82. DOI: 10.1002/da.10113. View

10.

Webb C, Hirshberg M, Davidson R, Goldberg S . Personalized Prediction of Response to Smartphone-Delivered Meditation Training: Randomized Controlled Trial. J Med Internet Res. 2022; 24(11):e41566. PMC: 9682449. DOI: 10.2196/41566. View

11.

DeRubeis R . The history, current status, and possible future of precision mental health. Behav Res Ther. 2019; 123:103506. DOI: 10.1016/j.brat.2019.103506. View

12.

McEwen B, Gianaros P . Stress- and allostasis-induced brain plasticity. Annu Rev Med. 2010; 62:431-45. PMC: 4251716. DOI: 10.1146/annurev-med-052209-100430. View

13.

Khoury B, Lecomte T, Fortin G, Masse M, Therien P, Bouchard V . Mindfulness-based therapy: a comprehensive meta-analysis. Clin Psychol Rev. 2013; 33(6):763-71. DOI: 10.1016/j.cpr.2013.05.005. View

14.

Spitzer R, Kroenke K, Williams J, Lowe B . A brief measure for assessing generalized anxiety disorder: the GAD-7. Arch Intern Med. 2006; 166(10):1092-7. DOI: 10.1001/archinte.166.10.1092. View

15.

Cheavens J, Strunk D, Lazarus S, Goldstein L . The compensation and capitalization models: a test of two approaches to individualizing the treatment of depression. Behav Res Ther. 2012; 50(11):699-706. DOI: 10.1016/j.brat.2012.08.002. View

16.

Bornemann B, Herbert B, Mehling W, Singer T . Differential changes in self-reported aspects of interoceptive awareness through 3 months of contemplative training. Front Psychol. 2015; 5:1504. PMC: 4284997. DOI: 10.3389/fpsyg.2014.01504. View

17.

Godara M, Hecht M, Singer T . Training-related improvements in mental well-being through reduction in negative interpretation bias: A randomized trial of online socio-emotional dyadic and mindfulness interventions. J Affect Disord. 2024; 354:662-672. DOI: 10.1016/j.jad.2024.03.037. View

18.

Jayewardene W, Lohrmann D, Erbe R, Torabi M . Effects of preventive online mindfulness interventions on stress and mindfulness: A meta-analysis of randomized controlled trials. Prev Med Rep. 2017; 5:150-159. PMC: 5199155. DOI: 10.1016/j.pmedr.2016.11.013. View

19.

Galatzer-Levy I, Huang S, Bonanno G . Trajectories of resilience and dysfunction following potential trauma: A review and statistical evaluation. Clin Psychol Rev. 2018; 63:41-55. DOI: 10.1016/j.cpr.2018.05.008. View

20.

Godara M, Silveira S, Matthaus H, Heim C, Voelkle M, Hecht M . Investigating differential effects of socio-emotional and mindfulness-based online interventions on mental health, resilience and social capacities during the COVID-19 pandemic: The study protocol. PLoS One. 2021; 16(11):e0256323. PMC: 8568275. DOI: 10.1371/journal.pone.0256323. View