Self-efficacy as a Mediator of Response to a Mindfulness Intervention for People with PTSD and Emotion Dysregulation 公开
Teer, Andrew (Fall 2020)
Published
Abstract
A subgroup of individuals with posttraumatic stress disorder (PTSD) experience high levels of emotion dysregulation; this population has been characterized by low levels of self-efficacy. Self-efficacy refers to the belief that one is able to perform the necessary actions in order to obtain a desired outcome. A lack of self-efficacy is thought to play a role in the development and maintenance of posttraumatic stress disorder. High levels of self-efficacy may buffer against the deleterious effects of trauma, possibly by decreasing avoidance. Mindfulness-based interventions have been shown to improve self-efficacy, particularly in populations with emotional dysregulation, and have likewise been successful in treating symptoms of PTSD. However, self-efficacy has not yet been examined as a potential mechanism through which mindfulness practices may improve emotion dysregulation and ameliorate PTSD symptoms. In this study, self-efficacy will be examined as a mediator of response to a brief breath-focused mindfulness meditation (BFMM) intervention for traumatized people with variable levels of emotion dysregulation. Response to this intervention will be measured both by changes in self-reported PTSD and emotion dysregulation and changes in a psychophysiological index of autonomic response (heart rate variability, or HRV). Participants were 55 women recruited for a BFMM intervention. Analyses of mediation and conditional indirect effects (i.e., moderated mediation) were performed with bootstrapped confidence intervals to facilitate statistical inference. Results demonstrated that the BFMM intervention did have its intended effects in reducing symptomatology and improving functioning, including increased coping self-efficacy. Changes in coping self-efficacy did not mediate the relationship between pre- and posttreatment 1) PTSD symptoms, 2) dissociative symptoms (as a proxy for emotion dysregulation), and 3) average HRV. Furthermore, average HRV did not correlate with any self-report measures tested. Lastly, moderated mediation analysis was conducted to examine whether or not the indirect effects of change in coping self-efficacy were conditionally affected by pretreatment emotion dysregulation, which was not supported by the data. Taken together, the findings point toward a more complex relationship between pretreatment emotion dysregulation and change in self-efficacy. And, as this study was significantly limited by sample size, interpreting the results must be done prudently.
Table of Contents
Background and Introduction……….………………………………………….....…1
Methodology…………………………………………………………………………….19
Results……………………………………………………………………………….……30
Discussion…………………………………………………………………………….….46
References…………………………………………………………………….………....52
Table 1…………………………………………………………………………………....64
Table 2…………………………………………………………………………………....64
Table 3…………………………………………………………………………………....65
Table 4…………………………………………………………………………………....66
Table 5…………………………………………………………………………………....67
Figure 1…………………………………………………………………………………...67
Figure 2…………………………………………………………………………………...68
Figure 3…………………………………………………………………………………...68
Figure 4…………………………………………………………………………………...69
Figure 5…………………………………………………………………………………...70
Figure 6…………………………………………………………………………………...71
Figure 7…………………………………………………………………………………...72
Figure 8..………………………………..………………………………………………..73
Figure 9..………………………………..………………………………………………..74
Figure 10………………………………………………………………………………….75
Figure 11………………………………………………………………………………….76
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