OBJECTIVE To explore mediated effects of Mindfulness-Based Cognitive Therapy-"Taking it Further" (MBCT-TiF) on mental well-being through changes in mindfulness, self-compassion, and decentering. METHOD A secondary analysis of an RCT using simple mediation, with 164 graduates of MBCT and mindfulness-based stress reduction (MBSR), was implemented whereby MBCT-TiF (vs ongoing mindfulness practice; OMP) was the independent variable; changes in mindfulness, self-compassion, and decentering during the intervention were the mediators; and mental well-being at post-intervention, whilst controlling for baseline, was the dependent variable. Secondary outcomes included psychological quality of life, depression, and anxiety. RESULTS Compared to OMP, MBCT-TiF experienced significant improvements in mental well-being through changes in all three mediators (mindfulness: ab = 0.11 [0.03, 0.25]; decentering: ab = 0.16 [0.05, 0.33]; self-compassion: ab = 0.07 [0.01, 0.18]). A similar pattern was demonstrated for depression, but only mindfulness and decentering mediated effects on psychological quality of life and anxiety. CONCLUSION The findings provide preliminary support for all three mediators in driving change in mental well-being in a sample of MBCT/MBSR graduates. Future work must be theory-driven and powered to test all mediators in parallel and alongside other potential mediators (e.g., equanimity) to further understand independent contributions and interacting effects.Trial registration: ClinicalTrials.gov identifier: NCT05154266.

中文翻译：

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基于正念的认知治疗（MBCT）和基于正念的减压（MBSR）毕业生的心理健康之路：随机对照试验的中介分析。

目的 探索基于正念的认知疗法“进一步发展”(MBCT-TiF) 通过正念、自我慈悲和去中心化的改变对心理健康的中介作用。方法 使用简单调解对 164 名 MBCT 和基于正念的减压 (MBSR) 毕业生进行的 RCT 进行二次分析，其中 MBCT-TiF（与持续的正念练习；OMP）为自变量；干预期间正念、自我慈悲和偏心的变化是中介因素；干预后的心理健康状况，同时控制基线，是因变量。次要结局包括心理生活质量、抑郁和焦虑。结果 与 OMP 相比，MBCT-TiF 通过所有三个中介变量的变化，使心理健康状况显着改善（正念：ab = 0.11 [0.03, 0.25]；偏心：ab = 0.16 [0.05, 0.33]；自我慈悲：ab = 0.07 [0.01, 0.18])。抑郁症也表现出类似的模式，但只有正念和偏心对生活心理质量和焦虑有中介作用。结论 这些研究结果为MBCT/MBSR 毕业生样本中推动心理健康变化的所有三个中介因素提供了初步支持。未来的工作必须是理论驱动的，并有动力并行地测试所有中介因素并与其他潜在中介因素（例如平静）一起测试，以进一步了解独立贡献和相互作用的影响。试验注册：ClinicalTrials.gov 标识符：NCT05154266。