Does enhanced meaning after meaning-centered group psychotherapy mediate a reduction in depressive symptoms in cancer survivors? A mediation analysis in the context of a randomized controlled trial Journal Article


Authors: Holtmaat, K.; van der Spek, N.; Rijnhart, J. J. M.; Lissenberg-Witte, B.; Breitbart, W.; Cuijpers, P.; Verdonck-de Leeuw, I. M.
Article Title: Does enhanced meaning after meaning-centered group psychotherapy mediate a reduction in depressive symptoms in cancer survivors? A mediation analysis in the context of a randomized controlled trial
Abstract: Purpose: After meaning-centered group psychotherapy for cancer survivors (MCGP-CS), depressive symptoms tend to decrease. An enhanced sense of meaning may play a mediating role in this decrease. The aim of this study was to assess whether personal meaning mediates the relationship between MCGP-CS and depressive symptoms. Methods: Cancer survivors (n = 114) were randomly allocated to MCGP-CS or care as usual (CAU). The assessments were scheduled at baseline, postintervention, and at 3- and 6-month follow-up. Mediation models were estimated based on structural equation modeling. We computed the indirect effect of MCGP-CS on depressive symptoms at the 3-month follow-up through personal meaning, and other meaning-related mediators, measured postintervention. Results: A small but significant indirect effect of MCGP-CS on depressive symptoms at the 3-month follow-up was found through personal meaning postintervention (b = − 0.29, 95% bootstrap CI (− 0.63, − 0.03)). There were no significant indirect effects through the other meaning-related factors. Conclusions: This study tentatively supports the MCGP-CS working model in that an enhanced sense of meaning as a result of MCGP-CS mediates a reduction in depressive symptoms. Personal meaning mediated a small effect of MCGP-CS on depressive symptoms. The longitudinal mediating effect of personal meaning occurred within a time period of 3 months after MCGP-CS. Relevance: MCGP-CS is a psychological intervention that supports cancer survivors in regaining or enhancing a sense of meaning in their lives. This enhanced sense of meaning is a protective factor against depressive symptoms. Trial registration: The RCT was registered in the Netherlands Trial Register (number NTR3571/NL3421) on August 10, 2012. © The Author(s), under exclusive licence to Springer-Verlag GmbH Germany, part of Springer Nature 2024.
Keywords: adult; controlled study; aged; middle aged; major clinical study; follow up; follow-up studies; antineoplastic agent; neoplasm; neoplasms; breast cancer; randomized controlled trial; clinical assessment; psychology; oncology; cancer survivor; depression; longitudinal studies; colon cancer; goal attainment; hormone; psychotherapy, group; mental health; therapy; group therapy; longitudinal study; psychological distress; etiology; cancer survivors; procedures; group psychotherapy; humans; human; male; female; article; malignant neoplasm; mediation analysis
Journal Title: Supportive Care in Cancer
Volume: 32
Issue: 12
ISSN: 0941-4355
Publisher: Springer Verlag  
Date Published: 2024-12-01
Start Page: 832
Language: English
DOI: 10.1007/s00520-024-09039-4
PUBMED: 39607536
PROVIDER: scopus
PMCID: PMC12042957
DOI/URL:
Notes: The MSK Cancer Center Support Grant (P30 CA008748) is acknowledged in the PubMed record and PDF -- Source: Scopus
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  1. William S Breitbart
    506 Breitbart