Target mechanisms of mindfulness
QUESTION Mindfulness-based programmes (MBPs) and practices have demonstrated effects in mental health and well-being, yet questions regarding the target mechanisms that drive change across the population remain unresolved. STUDY SELECTION AND ANALYSIS Five databases were searched for randomised controlled trials that evaluate the indirect effects (IEs) of an MBP or mindfulness practice in relation to mental health and well-being outcomes through psychological mechanisms. FINDINGS 27 eligible studies were identified, with only four exploring mechanisms in the context of specific mindfulness practices. Significant IEs were reported for mindfulness skills, decentering and attitudes of mindfulness (eg, self-compassion) across different outcomes, population samples, mental health strategies and active comparators. Evidence gap maps and requirements for testing and reporting IEs are provided to help guide future work. CONCLUSIONS Mindfulness skills, decentering and attitudes of mindfulness may be key intervention targets for addressing the mental health of whole populations. However, future work needs to address significant knowledge gaps regarding the evidence for alternative mechanisms (eg, attention and awareness) in relation to unique outcomes (eg, well-being), mental health strategies (ie, promotion) and active comparators. High-quality trials, with powered multivariate mediation analyses that meet key requirements, will be needed to advance this area of work. TRIAL REGISTRATION NUMBER 10.17605/OSF.IO/NY2AH.
中文翻译：
基于正念的计划和实践的目标机制：范围界定审查。
问题 基于正念的计划 （MBP） 和实践已证明对心理健康和福祉有影响，但关于推动整个人群变革的目标机制的问题仍未解决。研究选择和分析 检索了五个数据库的随机对照试验，这些试验通过心理机制评估 MBP 或正念练习与心理健康和福祉结果相关的间接影响 （IEs）。研究结果 确定了 27 项符合条件的研究，只有 4 项探讨了特定正念练习背景下的机制。在不同结果、人群样本、心理健康策略和积极对照中，正念技能、正念下降和正念态度（例如，自我同情）报告了显着的 IE。提供了测试和报告 IE 的证据差距图和要求，以帮助指导未来的工作。结论 正念技能、正念下降和正念态度可能是解决整个人群心理健康的关键干预目标。然而，未来的工作需要解决与独特结局（如幸福感）、心理健康策略（即促进）和积极对照相关的替代机制（如注意力和意识）证据的重大知识差距。需要高质量的试验，以及满足关键要求的有力多变量中介分析，以推进这一领域的工作。试验注册号 10.17605/OSF。IO/NY2AH 的。
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