OBJECTIVE Effective psychosocial interventions exist for numerous mental health conditions. However, despite decades of research, limited progress has been made in clarifying the mechanisms that account for their beneficial effects. We know that many treatments work, but we know relatively little about why they work. Mechanisms of change may be obscured due to prior research collapsing across heterogeneous subgroups of patients with differing underlying mechanisms of response. Studies identifying baseline individual characteristics that predict differential response (i.e., moderation) may inform research on why (i.e., mediation) a particular subgroup has better outcomes to an intervention via tests of moderated mediation. METHOD In a recent randomized controlled trial comparing a 4-week meditation app with a control condition in school system employees (N = 662), we previously developed a "Personalized Advantage Index" (PAI) using baseline characteristics, which identified a subgroup of individuals who derived relatively greater benefit from meditation training. Here, we tested whether the effect of mindfulness acquisition in mediating group differences in outcome was moderated by PAI scores. RESULTS A significant index of moderated mediation (IMM = 1.22, 95% CI [0.30, 2.33]) revealed that the effect of mindfulness acquisition in mediating group differences in outcome was only significant among those individuals with PAI scores predicting relatively greater benefit from the meditation app. CONCLUSIONS Subgroups of individuals may differ meaningfully in the mechanisms that mediate their response to an intervention. Considering subgroup-specific mediators may accelerate progress on clarifying mechanisms of change underlying psychosocial interventions and may help inform which specific interventions are most beneficial for whom. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

中文翻译：

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通过调节中介揭示特定于子组的变化机制：冥想干预示例。


目的 针对许多心理健康状况存在有效的社会心理干预。然而，尽管进行了数十年的研究，但在阐明解释其有益影响的机制方面取得的进展有限。我们知道许多治疗方法有效，但我们对它们为什么有效知之甚少。由于先前的研究在具有不同潜在反应机制的异质患者亚组中崩溃，因此变化机制可能被掩盖。确定预测差异反应（即调节）的基线个体特征的研究可能会通过调节中介测试为研究为什么（即中介）特定亚组对干预有更好的结果提供信息。方法 在最近的一项随机对照试验中，将为期 4 周的冥想应用程序与学校系统员工的控制条件 （N = 662） 进行比较，我们之前使用基线特征开发了一个“个性化优势指数”（PAI），该指数确定了从冥想训练中获得相对更大收益的个体亚组。在这里，我们测试了正念习得在中介结果组差异方面的影响是否受到 PAI 评分的调节。结果 适度中介的显著指数 （IMM = 1.22， 95% CI [0.30， 2.33]） 显示，正念习得在中介群体结果差异方面的影响仅在那些 PAI 评分预测冥想应用程序获益相对较大的个体中才显著。结论 个体亚组在中介他们对干预反应的机制上可能存在有意义的差异。 考虑针对亚组的中介可能会加快阐明社会心理干预背后的变化机制的进展，并可能有助于了解哪些特定的干预措施对谁最有益。（PsycInfo 数据库记录 （c） 2024 APA，保留所有权利）。