Chinh, KellyMosher, Catherine E.Brown, Linda F.Beck-Coon, Kathleen A.Kroenke, KurtJohns, Shelley A.2021-01-222021-01-222020Chinh, K., Mosher, C. E., Brown, L. F., Beck-Coon, K. A., Kroenke, K., & Johns, S. A. (2020). Psychological Processes and Symptom Outcomes in Mindfulness-Based Stress Reduction for Cancer Survivors: A Pilot Study. Mindfulness, 11(4), 905–916. https://doi.org/10.1007/s12671-019-01299-0https://hdl.handle.net/1805/24916Objectives 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.enPublisher Policycancerfatiguepsychological flexibilityArticle