Revealing subgroup-specific mechanisms of change via moderated mediation: A meditation intervention example.
Christian A. Webb, Matthew J. Hirshberg, Oscar González, Richard J. Davidson, Simon B. Goldberg
Journal of Consulting and Clinical Psychology September 28, 2023 DOI: 10.1037/ccp0000842 via OpenAlex
Summary
Mechanisms explaining why meditation training works may differ across patient subgroups. Prior research often collapsed heterogeneous groups, obscuring these differences. Using data from 662 participants, researchers developed a Personalized Advantage Index (PAI) to identify individuals likely to benefit more from a meditation app. A moderated mediation analysis showed that mindfulness acquisition mediated better outcomes only for those with higher PAI scores. This suggests that subgroup-specific mediators should be considered to clarify how psychosocial interventions work and to match individuals to the most beneficial treatment.
Study at a glance
| Characteristics | Randomized controlled trial Peer reviewed |
|---|---|
| Sample size | 662 |
| Population | Individuals participating in a meditation training study |
| Intervention | meditation app |
| Topics | Meditation |
| Keywords | Psychological intervention Psychosocial Psychotherapist Intervention counseling |
| Citations | 6 |
| Key finding | Mindfulness acquisition mediated group differences in outcome only among individuals whose baseline characteristics predicted greater benefit from the meditation app. |
Abstract
OBJECTIVE: they work. Mechanisms of change may be obscured due to prior research collapsing across heterogeneous subgroups of patients with differing underlying mechanisms of response. Studies identifying baseline individual characteristics that predict differential response (i.e., moderation) may inform research on why (i.e., mediation) a particular subgroup has better outcomes to an intervention via tests of moderated mediation. METHOD: = 662), we previously developed a "Personalized Advantage Index" (PAI) using baseline characteristics, which identified a subgroup of individuals who derived relatively greater benefit from meditation training. Here, we tested whether the effect of mindfulness acquisition in mediating group differences in outcome was moderated by PAI scores. RESULTS: A significant index of moderated mediation (IMM = 1.22, 95% CI [0.30, 2.33]) revealed that the effect of mindfulness acquisition in mediating group differences in outcome was only significant among those individuals with PAI scores predicting relatively greater benefit from the meditation app. CONCLUSIONS: Subgroups of individuals may differ meaningfully in the mechanisms that mediate their response to an intervention. Considering subgroup-specific mediators may accelerate progress on clarifying mechanisms of change underlying psychosocial interventions and may help inform which specific interventions are most beneficial for whom. (PsycInfo Database Record (c) 2024 APA, all rights reserved).