Psychological Processes and Symptom Outcomes in Mindfulness-Based Stress Reduction for Cancer Survivors: A Pilot Study

Kelly Chinh, Catherine E. Mosher, Linda F. Brown, Kathleen A. Beck-Coon, Kurt Kroenke, Shelley A. Johns

Research output: Contribution to journalArticle


Objectives: Growing evidence supports the efficacy of mindfulness-based interventions for symptoms in cancer survivors. Identifying theory-based psychological processes underlying their effects on symptoms would inform research to enhance their efficacy and cost-effectiveness. We conducted secondary analyses examining the effect of mindfulness-based stress reduction (MBSR) for cancer-related fatigue on mindfulness facets, self-compassion, and psychological inflexibility. We also examined whether changes in these processes were associated with the symptom outcomes of fatigue interference, sleep disturbance, and emotional distress. Methods: Thirty-five persistently fatigued cancer survivors (94% female, 77% breast cancer survivors) were randomized to either MBSR for cancer-related fatigue or a waitlist control (WC) condition. Self-report measures were administered at pre-intervention, post-intervention, and 1-month follow-up. Then the WC group received MBSR and completed a post-intervention follow-up. Results: Linear mixed modeling analyses of the first three time points showed steady increases over time for certain mindfulness facets (observing, acting with awareness, and nonjudging) and self-compassion in favor of the MBSR group. When analyzing pre- and post-intervention data across study conditions, none of the psychological processes predicted change in fatigue interference. However, increased nonjudging was associated with decreased sleep disturbance (β = −.39, p = 0.003), and increased acting with awareness was associated with decreased emotional distress (β = − 0.36, p = 0.003). Self-compassion did not predict change in symptom outcomes. Conclusions: Results point to specific psychological processes that may be targeted to maximize the efficacy of future MBSR interventions for cancer survivors.

Original languageEnglish (US)
Pages (from-to)905-916
Number of pages12
Issue number4
StatePublished - Apr 1 2020


  • Cancer
  • Fatigue
  • Mindfulness-based stress reduction
  • Psychological flexibility
  • Self-compassion

ASJC Scopus subject areas

  • Social Psychology
  • Health(social science)
  • Experimental and Cognitive Psychology
  • Developmental and Educational Psychology
  • Applied Psychology

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