Does patient expectancy account for the cognitive and clinical benefits of mindfulness training in older adults?

Objectives Patient expectations of treatment effects could influence neuropsychological and clinical outcomes in clinical trials of behavioral and lifestyle interventions, which could potentially confound the interpretation of findings. Our aim was to examine whether patient expectancy mediated effe...

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Bibliographic Details
Published in:International journal of geriatric psychiatry 2020-06, Vol.35 (6), p.626-632
Main Authors: Haddad, Rita, Lenze, Eric J., Nicol, Ginger, Miller, J. Philip, Yingling, Michael, Wetherell, Julie Loebach
Format: Article
Language:English
Subjects:
anxiety
clinical improvement
Clinical outcomes
Clinical trials
Cognitive ability
Credibility
depression
Expectancy
Geriatric psychiatry
Memory
Mental disorders
Mindfulness
Mindfulness‐Based Stress Reduction
older adults memory improvement
Older people
Patients
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Summary:Objectives Patient expectations of treatment effects could influence neuropsychological and clinical outcomes in clinical trials of behavioral and lifestyle interventions, which could potentially confound the interpretation of findings. Our aim was to examine whether patient expectancy mediated effectiveness of Mindfulness‐Based Stress Reduction (MBSR) for improving cognitive function and clinical outcome. Methods The present study uses data from a single‐blind, multi‐site, randomized controlled trial comparing MBSR to a health education attention control in older adults with anxiety and/or depressive disorders and subjective cognitive concerns. Using the Credibility and Expectations Questionnaire, we measured expectancy and perceived credibility of the interventions assigned to patients. Using mediational analysis, we examined the influence of expectancy and credibility on two key outcomes: memory performance and clinical global improvement. Results Neither expectancy nor perceived credibility of intervention accounted significantly for MBSR's effectiveness for memory test performance or clinical global improvement. Conclusion In this clinical trial, expectancy for improvement did not account for the effectiveness of MBSR on memory performance or clinical outcomes in depressed and anxious older adults. We advise that clinical trials of behavioral and lifestyle interventions for brain health in older adults should measure and test the role of expectancy.
ISSN:0885-6230
1099-1166
DOI:10.1002/gps.5279