Pilot randomized controlled trial of a mindfulness-based group intervention in adolescent girls at risk for type 2 diabetes with depressive symptoms.
Pilot randomized controlled trial of a mindfulness-based group intervention in adolescent girls at risk for type 2 diabetes with depressive symptoms.
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DOI：
10.1016/j.ctim.2017.04.003
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发表时间：
2017-06
影响因子：
3.6
通讯作者：
Bell C
中科院分区：
文献类型：
--
作者：
Shomaker LB;Bruggink S;Pivarunas B;Skoranski A;Foss J;Chaffin E;Dalager S;Annameier S;Quaglia J;Brown KW;Broderick P;Bell C
(1)评估在有抑郁症状的2型糖尿病(T2D)高危青少年女孩中基于正念的小组的可行性和可接受性，以及(2)比较基于正念的小组和认知行为小组在减少抑郁症状和改善胰岛素抵抗方面的效果。在一所大学进行的平行分组随机对照试点试验。33名12-17岁的女孩，有超重/肥胖，有糖尿病家族史，抑郁症状加重，被随机分成基于正念的(n=17)或认知-行为计划(n=16)，为期六周。这两种干预措施都包括每周六次、一小时的小组会议。以正念为基础的项目包括有指导的正念意识练习。认知-行为计划包括认知重建和行为激活。在基线、干预后和6个月后对青少年进行评估。可行性/可接受性通过出席率和项目评级来衡量。抑郁症状通过验证性调查进行评估。胰岛素抵抗是通过空腹胰岛素和血糖来确定的，并使用双能X射线吸收法来评估身体成分。大多数青少年参加了80%的≥课程(正念：92%与认知-行为：87%，p=1.00)。可接受性评级很高。在治疗后和六个月后，正念状态的青少年比认知行为状态的青少年抑郁症状的减少更大(PS<；0.05)。与认知行为状况相比，正念干预的青少年在治疗后的胰岛素抵抗和空腹胰岛素方面也有更大的下降，调整了脂肪量和其他协变量(PS<；0.05)。以正念为基础的干预表明，在有抑郁症状的T2D高危女孩中，这种干预是可行的和可接受的。与认知行为项目相比，在干预后，接受正念训练的青少年在抑郁症状和更好的胰岛素抵抗方面表现出更大的缓解。
(1) Evaluate feasibility and acceptability of a mindfulness-based group in adolescent girls at-risk for type 2 diabetes (T2D) with depressive symptoms, and (2) compare efficacy of a mindfulness-based versus cognitive-behavioral group for decreasing depressive symptoms and improving insulin resistance. Parallel-group, randomized controlled pilot trial conducted at a university. Thirty-three girls 12-17y with overweight/obesity, family history of diabetes, and elevated depressive symptoms were randomized to a six-week mindfulness-based (n=17) or cognitive-behavioral program (n=16). Both interventions included six, one-hour weekly group sessions. The mindfulness-based program included guided mindfulness awareness practices. The cognitive-behavioral program involved cognitive restructuring and behavioral activation. Adolescents were evaluated at baseline, post-intervention, and six-months. Feasibility/acceptability were measured by attendance and program ratings. Depressive symptoms were assessed by validated survey. Insulin resistance was determined from fasting insulin and glucose, and dual energy x-ray absorptiometry was used to assess body composition. Most adolescents attended ≥80% sessions (mindfulness:92% versus cognitive-behavioral:87%, p=1.00). Acceptability ratings were strong. At post-treatment and six-months, adolescents in the mindfulness condition had greater decreases in depressive symptoms than adolescents in the cognitive-behavioral condition (ps<.05). Compared to the cognitive-behavioral condition, adolescents in the mindfulness-based intervention also had greater decreases in insulin resistance and fasting insulin at post-treatment, adjusting for fat mass and other covariates (ps<.05). A mindfulness-based intervention shows feasibility and acceptability in girls at-risk for T2D with depressive symptoms. Compared to a cognitive-behavioral program, after the intervention, adolescents who received mindfulness showed greater reductions in depressive symptoms and better insulin resistance.
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