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Brief mentalizing imagery therapy reduces stress and enhances positive psychological traits in family dementia caregivers: mediation by mindfulness.

Paulina Gutierrez-Ramirez, Liliana A Ramirez Gomez, Miranda Zea, Maren Nyer, Kimberly Dueck, Finale Doshi-Velez, Felipe A Jain

Aging & mental health June 24, 2025 DOI: 10.1080/13607863.2025.2519622 via PubMed

Summary

A 4-week mentalizing imagery therapy (MIT) combining mindfulness and guided imagery reduced perceived stress and improved resilience, spiritual well-being, and other positive psychological traits in family dementia caregivers compared to a psychosocial support group. Changes in dispositional mindfulness from before to after the program explained the improvements for most outcomes. The pilot trial involved 46 participants and used longitudinal analyses. The authors suggest that larger studies should confirm these benefits and explore how mindfulness mediates effects over time.

Study at a glance

Characteristics Pilot randomized controlled trial Longitudinal Pilot study Peer reviewed
Sample size 46
Population Family dementia caregivers
Interventions Mentalizing imagery therapy Psychosocial support group
Duration 4-week intervention, 4-month follow-up
Topics Meditation
Keywords Family caregivers Stress/burden Caregiving Eudaimonia Perceived stress
Key finding MIT reduced perceived stress and improved resilience and other positive psychological traits compared to a support group, with changes in mindfulness mediating most outcomes.

Abstract

Family dementia caregivers exhibit high rates of chronic psychological stress. We aimed to determine the impact of mentalizing imagery therapy (MIT), a mindfulness and guided imagery approach, on perceived stress and positive psychological traits. We further investigated the role of dispositional mindfulness on these effects. This analysis of secondary outcomes drew from a pilot randomized controlled trial (n = 46) of 4-week MIT versus a psychosocial support group for family dementia caregivers. Measures of perceived stress, resilience, and other positive psychological traits were administered at baseline, post-group, and four months. Longitudinal analyses were conducted with mixed linear models, and mediation analyses with bootstrapping, in R. MIT demonstrated statistically significant benefits relative to the support group for perceived stress, resilience, spiritual well-being, and other positive traits. Changes from baseline to post-group in mindfulness significantly mediated the relationships between group and most outcomes. In this pilot trial, MIT reduced perceived stress and improved positive psychological traits. Mediation by dispositional mindfulness was demonstrated. Future research in larger samples should be aimed at confirming the benefits of short-term MIT on reducing stress and improving positive psychological traits, and studying the time course of mediation effects by mindfulness.

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