Mindfulness Mediates the Effect of a Psychological Online Intervention for Psychosis on Self-Reported Hallucinations: A Secondary Analysis of Voice Hearers From the EviBaS Trial

Abstract

<i>Background</i>: Psychological online interventions (POIs) could represent a promising approach to narrow the treatment gap in psychosis but it remains unclear whether improving mindfulness functions as a mechanism of change in POIs. For the present study, we examined if mindfulness mediates the effect of a comprehensive POI on distressing (auditory) hallucinations.<p>

<p><i>Methods</i>: We conducted a secondary analysis on voice hearers (n = 55) from a randomized controlled trial evaluating a POI for psychosis (EviBaS; trial registration NCT02974400, clinicaltrials.gov). The POI includes a module on mindfulness and we only considered POI participants in our analyses who completed the mindfulness module (<i>n</i> = 16).<p>

<p><i>Results</i>: Participants who completed the mindfulness module reported higher mindfulness (p = 0.015) and lower hallucinations (p = 0.001) at post assessment, compared to controls, but there was no effect on distress by voices (<i>p</i> = 0.598). Mindfulness mediated the POI’s effect on hallucinations (<i>b</i> = −1.618, LLCI = −3.747, ULCI = −0.054) but not on distress by voices (<i>b</i> = −0.057, LLCI = −0.640, ULCI = 0.915).