Mindfulness, coping, and optimism as mechanisms of change in the 3RP-NF intervention.
Victoria A Grunberg, Jafar Bakhshaie, Heena Manglani, Julia Hooker, Elizabeth A Rochon, Ana-maria Vranceanu
Journal of clinical psychology February 1, 2024 DOI: 10.1002/jclp.23623
Summary
Adults with neurofibromatosis (NF) experience significant challenges, including a 72% prevalence of depression and anxiety, leading to poor quality of life. The "Relaxation Response Resiliency for NF" program, involving 114 participants aged 18-70, identified key mechanisms that improve outcomes. Coping was the strongest mediator for quality of life improvements, while mindfulness significantly reduced depression and anxiety. Specifically, coping accounted for nearly 97% of quality of life enhancement, while mindfulness accounted for 26% and 23% reductions in depression and anxiety, respectively.
Abstract
Neurofibromatosis (NF) is chronic neurogenetic condition that increases risk for poor quality of life, depression, and anxiety. Given the lack of biomedical treatments, we developed the "Relaxation Response Resiliency for NF" (3RP-NF) program to improve psychosocial outcomes among adults with NF. To move toward effectiveness testing, we must understand mechanisms that explained treatment effects. We tested whether our hypothesized mechanisms of change-mindfulness, coping, and optimism-mediated improvements in quality of life, depression, and anxiety among adults in the 3RP-NF program (N = 114; ages 18-70; 72.80% female; 81.58% White). We conducted mixed-effects models to assess whether these mechanisms uniquely mediated outcomes. Improvements in quality of life were most explained by coping, (b = 0.97, SE = 0.28, CI [0.45, 1.56]), followed by mindfulness (b = 0.46, SE = 0.17, CI [0.15, 0.82]) and optimism (b = 0.39, SE = 0.12, CI [0.17, 0.65]). Improvements in depression and anxiety were most explained by mindfulness (b = -1.52, SE = 0.38, CI [-2.32, -0.85], CSIE = -0.26; b = -1.29, SE = 0.35, CI [-2.04, -0.67], CSIE = -0.23), followed by optimism (b = 0.39, SE = 0.12, CI [0.17, 0.65]; b = -0.49, SE = 0.20, CI [-0.91, -0.13]), but were not explained by coping (b = 0.22, SE = 0.43, CI [-0.62, 1.07]; b = 0.06, SE = 0.46, CI [-0.84, 0.97]), respectively. Targeting mindfulness, coping, and optimism in psychosocial interventions may be a promising way to improve the lives of adults with NF.